: This is a competing renewal application for the California NeuroAIDS Tissue Network (CNTN), which had the overarching aim of creating a tissue bank of CNS autopsy material from AIDS patients who were well characterized neuropsychologically and neuromedically prior to their death. The CNTN is comprised of five sites, which care for approximately 5000 AIDS patients: UCSF-San Francisco General Hospital; LA County + (USC) Medical Center; Harbor-UCLA Medical Center/Cedars-Sinai Medical Center; UC Irvine-Orange County Medical Center. To date, the CNTN has examined 310 persons with AIDS of whom 85 have died. Autopsy was completed on 57 of these. In addition, the CNTN has tissues from 31 AIDS patients on whom only limited clinical data [medical records] are available, as well as tissues from 9 HIV uninfected persons, for a total of 97 brain specimens. Among the specimens in the bank are 237 paired blood-CSF specimens taken from living persons and 57 blood/CSF pairs derived from autopsy. CNTN participates in the Nations NeuroAIDS Tissue Consortium [NNTC], a partnership of the four NIH-funded neuroAIDS tissue banks. CNTN activities have included active contribution to the development of the NNTC protocol and quality assurance activities, as well as fulfillment of tissue and sample requests. The overall objective in this renewal is to increase recruitment of maximally informative participants, thus enhancing the accrual of tissues and specimens. Protocol modifications acknowledge improved survival of persons with AIDS, as well as the need to characterize comorbidities [e.g. Hepatitis C] and to detail treatment regimens in a manner that will enhance the usefulness of tissues to investigators. To achieve these aims we will enroll 446 new cases with an emphasis on those with CD4<100. With a steady state of 280 living participants, we estimate we will accumulate tissues from 213 new autopsies from the anticipated 300 deaths in the longitudinal cohort. We plan also to add 74 additional HIV + cases dying at our centers for whom only limited antemortem data will be available, as well as 41 HIV seronegative comparison case tissues. The work of the clinical sites will be coordinated by the Administrative, Protocol Monitoring, and Data Management and Information Systems Units at UCSD. The CNTN Neuropathology and Banking Unit at UCSD will collect, process catalogue, bank, and disburse tissue and fluid samples. The CNTN will coordinate its work closely with that of the other NNTC sites to assure that the entire NNTC develops as a national and international resource for research on neuroAIDS.
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