A critical barrier to progress in multidisciplinary clinical research on HIV and aging is the paucity in clinical studies to date of truly older HIV-infected (HIV+) individuals - those in whom the synergistic effects of HIV and age on brain structure and function are most likely to be observed. Although HIV+ people in the U.S. are now living into old age with long-term combination antiretroviral treatment (CART) and the U.S. CDC estimates that by 2015 more than 10% of all HIV+ individuals will exceed 65 years of age (i.e., older HIV+), very few such individuals have actually been included in published reports. We propose to capitalize on a unique geographic concentration of HIV+ individuals over age 65 in a cluster of desert communities nearby to San Diego, where their proportion has already exceeded 10%. We will establish a productive, collaborative partnership between the aging HIV+ community in Riverside County and the multidisciplinary UCSD HIV Neurobehavioral Research Center (HNRC) to investigate neurological functioning among older HIV+ individuals. We will strengthen and evolve an emerging alliance between desert community activists and HNRC researchers. We will leverage the well- established, NIMH-funded HNRC infrastructure to establish this new cohort with modest support. We will demonstrate feasibility by training local personnel in high-quality clinical research evaluations and by establishing an initial cohort of 20 well-characterized older HIV+ persons. These preliminary efforts will support the establishment of an expanded clinical research infrastructure for planned future studies on interventions to maximize neurological health, productivity and quality of life in the "oldest old" HIV+ persons.

Public Health Relevance

Extended survival among individuals on combination antiretroviral therapy has resulted in a growing population of aging persons with HIV infection. This population is vulnerable to the premature occurrence of common age-associated diseases that cause neurological disability and adversely affect public health. This project will begin to delineate the public health burden of these disorders in a unique geographic cluster of such individuals affected by advanced aging with HIV infection.

Agency
National Institute of Health (NIH)
Type
Small Research Grants (R03)
Project #
5R03AG044910-02
Application #
8735839
Study Section
Special Emphasis Panel (ZRG1)
Program Officer
Eldadah, Basil A
Project Start
Project End
Budget Start
Budget End
Support Year
2
Fiscal Year
2014
Total Cost
Indirect Cost
Name
University of California San Diego
Department
Neurosciences
Type
Schools of Medicine
DUNS #
City
La Jolla
State
CA
Country
United States
Zip Code
92093
CaƱizares, Silvia; Cherner, Mariana; Ellis, Ronald J (2014) HIV and aging: effects on the central nervous system. Semin Neurol 34:27-34