Effective antiretroviral therapy (ART) has resulted in many people with chronic HIV surviving into middle and old age. However, even those with controlled HIV viral replication, are more likely than uninfected subjects to experience premature chronic illness, multi-morbidity and functional decline. For example, 58% of HIV- infected subjects age >= 50 years have one or more of the following: renal failure, diabetes mellitus, bone fracture, hypertension or overt cardiovascular disease vs. only 35% of HIV-uninfected controls. Further, geriatric syndromes such as frailty and falls are becoming more prevalent in HIV-infected adults. While the need for research in HIV and aging is widely recognized, challenges in methodology, data acquisition and sharing, and research workforce education/training have hampered this goal. Multi-morbidity, functional decline and disability are typically research domains of geriatrics and gerontology. The Claude D. Pepper Older Americans Independence Centers (OAlCs;aka "Pepper Centers") were established to advance research into the causes, mechanisms, prevention and treatment of functional decline with age, but lack expertise in HIV. In contrast, the Centers for AIDS Research (CFARs) have unparalleled expertise in HIV- related basic, clinical and social/behavioral research, but lack resources or expertise in aging biology, clinical phenotypes, or functional measures. This proposal leverages CFAR/OAIC expertise to create a shared research platform, enhancing and accelerating investigation at the interface of HIV and aging by: 1) Harmonizing processes for data collection across OAlCs and CFARs and providing a coordinated platform for data collection;2) Validating key instruments/measures of function and geriatric phenotypes in HIV- infected subjects age >50 years;3) Supporting pilot projects at the interface of HIV and aging;4) Identifying and mentoring junior faculty with a research focus in HIV and aging;and 5) Disseminating information and data sharing opportunities to the larger scientific community. Accomplishing these aims will efficiently amplify NIAID investment in the CFARs, NIA investment in the OAlCs, and, more importantly, address critical healthcare needs in a rapidly growing population aging with HIV.

Public Health Relevance

It is estimated that half of all U.S. HIV-infected persons will be >50 yrs by 2015, however, HIV-infection and its treatment result in premature co-morbidity and functional decline. This proposal addresses a high priority area identified by both the Office of AIDS Research and NIA, is responsive to goals outlined in PA-12-064, and will efficiently leverage the interdisciplinary resources of the NIA and NIAID.

Agency
National Institute of Health (NIH)
Institute
National Institute on Aging (NIA)
Type
Resource-Related Research Projects (R24)
Project #
5R24AG044325-02
Application #
8729392
Study Section
National Institute on Aging Initial Review Group (NIA)
Program Officer
Salive, Marcel
Project Start
2013-09-01
Project End
2018-05-31
Budget Start
2014-06-01
Budget End
2015-05-31
Support Year
2
Fiscal Year
2014
Total Cost
$451,482
Indirect Cost
$132,157
Name
Wake Forest University Health Sciences
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
937727907
City
Winston-Salem
State
NC
Country
United States
Zip Code
27157
Pathai, Sophia; Bajillan, Hendren; Landay, Alan L et al. (2014) Is HIV a model of accelerated or accentuated aging? J Gerontol A Biol Sci Med Sci 69:833-42
High, Kevin P (2014) Infrastructure and resources for an aging population: embracing complexity in translational research. Transl Res 163:446-55