Over 25 years since recognition of the HIV pandemic, the HIV-infected subjects have moved toward older ages due to improvements in antiretroviral therapy. Non-AIDS-defining co-morbidities such as atherosclerosis, neurocognitive decline and osteoporosis occur despite viral suppression, presenting intriguing similarities to old age. Highly active anti-retroviral therapy (HAART) has reduced mortality in the last decade though mortality rate in HIV-infected African Americans is higher as compared to Hispanic, Asians or whites. Although the reasons for the disparities are poorly understood, psychosocial stress is one factor that may account for the poorer clinical outcomes in HIV-infected subjects in African Americans compared to Whites. The goal of this proposal is to test the hypothesis that immune perturbations, namely immune activation and inflammation, in HIV-infected subjects will contribute to early immune senescence and that these perturbations are enhanced in African Americans compared to white HIV-infected subjects contributing to early senescence and faster HIV disease progression. This project will also test the hypothesis that psychosocial stress may account for the increased activation, inflammation and senescence in African Americans compared to white HIV infected subjects as well as more rapid disease progression. We will conduct this study in specimens from the Rush CEDHA Repository of the Research Core. Novel to this application we will study whether innate immune activation contributes to immune senescence and use telomere shortening as a measure of senescence. We will evaluate immune perturbations, immune activation (HLADR+ CD38+ expression on CD4 and CDS T cells), innate cell activation (soluble CD14, type 1 intereferon-alpha and beta), inflammation (pro- and anti) TNF-alpha, IL-6, IL-10) and immune senescence (defined as CD28-CD57+ expression on CD4 and CDS T cells and telomere length) in age matched HIV infected and uninfected individuals (age 50-60) and older HIV-uninfected (age >70), a unique population accessible via the Research Core of Rush CEDHA. Impact of race and psychosocial stress on immune perturbation will be evaluated in HIV infected subjects. This project has a cross discipline expertise, from leading clinicians in the HIV/AIDS field, immunologists, neuropsychologist and bio-statiscian for successful implementation of the aims and objectives of this study.

Public Health Relevance

Underlining biological mechanism, immune activation/inflammation and patho-physiological mechanism such as psycho-social stress in African Americans will give insight into early aging and high mortality rates in HIV-infected African Americans versus whites. The results of this study will help design intervention strategies towards stress reduction in HIV-infected African Americans to prevent comorbidities.

National Institute of Health (NIH)
National Institute on Minority Health and Health Disparities (NIMHD)
Exploratory Grants (P20)
Project #
Application #
Study Section
Special Emphasis Panel (ZMD1-RN)
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
Rush University Medical Center
United States
Zip Code
Rodrigues, Jovita; Capuano, Ana W; Barnes, Lisa L et al. (2018) Effect of Antidepressant Medication Use and Social Engagement on the Level of Depressive Symptoms in Community-Dwelling, Older African Americans and Whites With Dementia. J Aging Health :898264318772983
Jansen, Willemijn J; Wilson, Robert S; Visser, Pieter Jelle et al. (2018) Age and the association of dementia-related pathology with trajectories of cognitive decline. Neurobiol Aging 61:138-145
Nguyen, Annie L; McNeil, Candice J; Han, S Duke et al. (2018) Risk and protective factors for health-related quality of life among persons aging with HIV. AIDS Care 30:518-522
Krueger, Kristin R; Adeyemi, Oluwatoyin; Leurgans, Sue et al. (2017) Association of cognitive activity and neurocognitive function in blacks and whites with HIV. AIDS 31:437-441
Han, S Duke; Adeyemi, Oluwatoyin; Wilson, Robert S et al. (2017) Loneliness in Older Black Adults with Human Immunodeficiency Virus Is Associated with Poorer Cognition. Gerontology 63:253-262
Turner, Arlener D; James, Bryan D; Capuano, Ana W et al. (2017) Perceived Stress and Cognitive Decline in Different Cognitive Domains in a Cohort of Older African Americans. Am J Geriatr Psychiatry 25:25-34
Arvanitakis, Zoe; Fleischman, Debra A; Arfanakis, Konstantinos et al. (2016) Association of white matter hyperintensities and gray matter volume with cognition in older individuals without cognitive impairment. Brain Struct Funct 221:2135-46
Lim, Andrew S P; Fleischman, Debra A; Dawe, Robert J et al. (2016) Regional Neocortical Gray Matter Structure and Sleep Fragmentation in Older Adults. Sleep 39:227-35
Arfanakis, Konstantinos; Wilson, Robert S; Barth, Christopher M et al. (2016) Cognitive activity, cognitive function, and brain diffusion characteristics in old age. Brain Imaging Behav 10:455-63
Fleischman, Debra A; Yang, Jingyun; Arfanakis, Konstantinos et al. (2015) Physical activity, motor function, and white matter hyperintensity burden in healthy older adults. Neurology 84:1294-300

Showing the most recent 10 out of 21 publications