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 #
3R24AG044325-03S1
Application #
9003203
Study Section
Neuroscience of Aging Review Committee (NIA)
Program Officer
Salive, Marcel
Project Start
2013-09-01
Project End
2016-05-31
Budget Start
2015-06-01
Budget End
2016-05-31
Support Year
3
Fiscal Year
2015
Total Cost
Indirect Cost
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
North, Crystal M; Muyanja, Daniel; Kakuhikire, Bernard et al. (2018) Brief Report: Systemic Inflammation, Immune Activation, and Impaired Lung Function Among People Living With HIV in Rural Uganda. J Acquir Immune Defic Syndr 78:543-548
Mitton, Julian A; North, Crystal M; Muyanja, Daniel et al. (2018) Smoking cessation after engagement in HIV care in rural Uganda. AIDS Care 30:1622-1629
North, Crystal M; Allen, Joseph G; Okello, Samson et al. (2018) HIV Infection, Pulmonary Tuberculosis, and COPD in Rural Uganda: A Cross-Sectional Study. Lung 196:49-57
Pérez-Santiago, Josué; De Oliveira, Michelli F; Var, Susanna R et al. (2017) Increased cell-free mitochondrial DNA is a marker of ongoing inflammation and better neurocognitive function in virologically suppressed HIV-infected individuals. J Neurovirol 23:283-289
Siedner, Mark J (2017) Aging, Health, and Quality of Life for Older People Living With HIV in Sub-Saharan Africa: A Review and Proposed Conceptual Framework. J Aging Health :898264317724549
Feinstein, Matthew J; Kim, June-Ho; Bibangambah, Prossy et al. (2017) Ideal Cardiovascular Health and Carotid Atherosclerosis in a Mixed Cohort of HIV-Infected and Uninfected Ugandans. AIDS Res Hum Retroviruses 33:49-56
Valdez, Arielle N; Rubin, Leah H; Neigh, Gretchen N (2016) Untangling the Gordian knot of HIV, stress, and cognitive impairment. Neurobiol Stress 4:44-54
High, Kevin P (2014) Infrastructure and resources for an aging population: embracing complexity in translational research. Transl Res 163:446-55
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