NeuroAIDS in India Viral and host factors, as well as comorbidities, play key roles in determining susceptibility to the neurologic complications associated with HIV infection. Most studies of HIV-related neurocognitive impairment have been conducted in Western countries, where HIV clade B predominates. Worldwide, however, clade C is much more common and recent virologic studies suggest that its neurovirulence may differ from clade B. Approximately 5 million individuals are infected with HIV in India, the vast majority with clade C virus. In the present study we will address the following aims within an Indian cohort: 1) to determine the prevalence and nature of HIV-associated neurocognitive impairment (HNCI) in HIV-infected individuals who are not on antiretroviral (ARV) therapy, 2) to determine the impact of newly-initiated ARV treatment on cognitive functioning, 3) to assess the viral (env, tat) genetics associated with HNCI, and 4) to determine the relationship between HNCI and host immunogenetic factors (i.e., genotype MCP-1, CCL3L1 copy number, RANTES and polymorphisms in CCR5/CCR2 to define CCR5 haplotypes). Building upon collaboration between the HIV Neurobehavioral Research Center (HNRC) in the U.S. and the National AIDS Research Institute (NARI) in Pune, India, we propose to examine 300 HIV+ individuals prior to initiation of ARVs in linked studies (HPTN 052, India National AIDS Control Organization program) and follow them annually thereafter. We will also enroll an HIV seronegative comparison group in order to establish neuropsychological norms for determining impairment in individual HIV+ persons. The feasibility of this study has been demonstrated by a pilot study in which we created Marathi-translated instruments, trained India personnel, and examined 60 participants using methods originally developed at the HNRC but adapted to India. This project will potentially a) lead to improved understanding of the characteristics and correlates of neurologic complications of clade C HIV infection in India and b) enhance existing clinical and scientific expertise in India via technology transfer in the areas of cognitive assessments, genomics, and biomarker assays.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Research Project (R01)
Project #
5R01MH078748-04
Application #
7848282
Study Section
NeuroAIDS and other End-Organ Diseases Study Section (NAED)
Program Officer
Joseph, Jeymohan
Project Start
2007-06-01
Project End
2012-05-31
Budget Start
2010-06-01
Budget End
2011-05-31
Support Year
4
Fiscal Year
2010
Total Cost
$568,839
Indirect Cost
Name
University of California San Diego
Department
Psychiatry
Type
Schools of Medicine
DUNS #
804355790
City
La Jolla
State
CA
Country
United States
Zip Code
92093
Jumare, Jibreel; El-Kamary, Samer S; Magder, Laurence et al. (2018) Body Mass Index and Cognitive Function among HIV-1 Infected Individuals in China, India and Nigeria. J Acquir Immune Defic Syndr :
Fazeli, Pariya L; Moore, David J; Franklin, Donald R et al. (2016) Lower CSF A? is Associated with HAND in HIV-Infected Adults with a Family History of Dementia. Curr HIV Res 14:324-30
Ma, Qing; Vaida, Florin; Wong, Jenna et al. (2016) Long-term efavirenz use is associated with worse neurocognitive functioning in HIV-infected patients. J Neurovirol 22:170-8
Ghate, Manisha; Mehendale, Sanjay; Meyer, Rachel et al. (2015) The effects of antiretroviral treatment initiation on cognition in HIV-infected individuals with advanced disease in Pune, India. J Neurovirol 21:391-8
Malvar, Jemily; Vaida, Florin; Sanders, Chelsea Fitzsimons et al. (2015) Predictors of new-onset distal neuropathic pain in HIV-infected individuals in the era of combination antiretroviral therapy. Pain 156:731-9
Heaton, Robert K; Akshoomoff, Natacha; Tulsky, David et al. (2014) Reliability and validity of composite scores from the NIH Toolbox Cognition Battery in adults. J Int Neuropsychol Soc 20:588-98
Tilghman, Myres W; Bhattacharya, Jayanta; Deshpande, Suprit et al. (2014) Genetic attributes of blood-derived subtype-C HIV-1 tat and env in India and neurocognitive function. J Med Virol 86:88-96
Grant, Igor; Franklin Jr, Donald R; Deutsch, Reena et al. (2014) Asymptomatic HIV-associated neurocognitive impairment increases risk for symptomatic decline. Neurology 82:2055-62
Weintraub, Sandra; Dikmen, Sureyya S; Heaton, Robert K et al. (2013) Cognition assessment using the NIH Toolbox. Neurology 80:S54-64
Nguyen, Anh; Rossi, Steven; Croteau, David et al. (2013) Etravirine in CSF is highly protein bound. J Antimicrob Chemother 68:1161-8

Showing the most recent 10 out of 14 publications