Advances in antiretroviral therapy have reduced but not eliminated mortality and neurologic morbidity related to HIV infection. The epidemic has been transformed into a chronic disease in which there is a dynamic equilibrium between mechanisms maintaining viral persistence and host immune strategies that, in combination with antiretroviral therapy, hold viral activity in check. Prospects for eradication or cure are many years or decades away. Looking toward the future, the HNRC perceives four general areas in which research needs are greatest. In the renewal period, the Neuromedical Core (NMC) will therefore develop and mature its research infrastructure to support studies addressing the themes of aging, acute and early HIV infection and clinical relevance. A common thread linking these three themes is genetics-both host and viral. The newly-organized NMC is made up of two cooperative units comprising common resources (equipment, supplies) and staff that interact on a daily basis: a Clinical Research Support Unit (CRSU);and a Laboratory, Pharmacology &Biomarker Unit (LPBU). Together these units will perform evaluations on all HIV+ subjects and HIV- controls, including those enrolled in pilot studies of the Developmental Core. The over-arching objectives of the Neuromedical Core (NMC) are to provide comprehensive clinical and laboratory evaluations, scientific consultation, and mentorship, training, and community education in NeuroAIDS. In the current funding period the NMC facilitated 70 research projects including observational cohort studies, clinical-pathological investigations, imaging studies, clinical trials and international research performed by collaborating investigators at UCSD and many other institutions. By assisting investigators in widely diverging disciplines at all levels of project development, from conceptualization of hypotheses to study implementation, analysis, interpretation and dissemination, the NMC encourages the application of multiple scientific perspectives and stimulates interdisciplinary collaboration and coordination. Through a variety of flexible mechanisms including face-to-face meetings and video teleconferences we will collaborate closely with the Neuroimaging, Neurobehavioral, Neurovirology, Neurobiology, Developmental and International Cores to further the HNRC's transdisciplinary aims.

Public Health Relevance

Antiretroviral therapy has transformed the HIV epidemic in the US into a chronic, manageable disease, but prospects for eradication or cure are many years or decades away. As the population of surviving HIV+ individuals ages, public health priorities in neuroAIDS will increasingly shift towards dealing with diseases and disabilities resulting from the interaction of aging and HIV, including Alzheimer's disease and cerebrovascular disease.

National Institute of Health (NIH)
National Institute of Mental Health (NIMH)
Center Core Grants (P30)
Project #
Application #
Study Section
Special Emphasis Panel (ZMH1-ERB-M)
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
University of California San Diego
La Jolla
United States
Zip Code
Heaton, Robert K; Franklin Jr, Donald R; Deutsch, Reena et al. (2015) Neurocognitive change in the era of HIV combination antiretroviral therapy: the longitudinal CHARTER study. Clin Infect Dis 60:473-80
Hobkirk, Andréa L; Starosta, Amy J; De Leo, Joseph A et al. (2015) Psychometric validation of the BDI-II among HIV-positive CHARTER study participants. Psychol Assess 27:457-66
Morgan, Erin E; Iudicello, Jennifer E; Cattie, Jordan E et al. (2015) Neurocognitive impairment is associated with lower health literacy among persons living with HIV infection. AIDS Behav 19:166-77
Casaletto, K B; Obermeit, L; Morgan, E E et al. (2015) Depression and executive dysfunction contribute to a metamemory deficit among individuals with methamphetamine use disorders. Addict Behav 40:45-50
Repunte-Canonigo, Vez; Lefebvre, Celine; George, Olivier et al. (2014) Gene expression changes consistent with neuroAIDS and impaired working memory in HIV-1 transgenic rats. Mol Neurodegener 9:26
Fazeli, Pariya L; Woods, Steven Paul; Heaton, Robert K et al. (2014) An active lifestyle is associated with better neurocognitive functioning in adults living with HIV infection. J Neurovirol 20:233-42
Andrade, Rosa M; Torriani, Francesca J; Ellis, Ronald J (2014) Acute HIV infection presenting as fulminant meningoencephalitis with massive CSF viral replication. Neurol Clin Pract 4:256-259
Orlov, Marika; Vaida, Florin; Williamson, Kathryn et al. (2014) Antigen-presenting phagocytic cells ingest malaria parasites and increase HIV replication in a tumor necrosis factor ?-dependent manner. J Infect Dis 210:1562-72
Overk, Cassia R; Masliah, Eliezer (2014) Pathogenesis of synaptic degeneration in Alzheimer's disease and Lewy body disease. Biochem Pharmacol 88:508-16
Akolo, Christopher; Royal 3rd, Walter; Cherner, Mariana et al. (2014) Neurocognitive impairment associated with predominantly early stage HIV infection in Abuja, Nigeria. J Neurovirol 20:380-7

Showing the most recent 10 out of 313 publications