This application is a request for a Mentored Patient-Oriented Research Career Award (K23) to provide Dr. Robert Paul the requisite training and expertise to investigate treatment outcome in patients infected with human immunodeficiency virus (HIV). Training will be obtained through intensive didactic and hands-on research experiences available through collaboration with Dr. Timothy Flanigan (sponsor), and Drs. Charles Carpenter, Bradford Navia, Charles Hinkin, and Ronald Cohen. The applicant will also participate in training opportunities associated with the Center for AIDS Research and T32 Training Programs based at Miriam Hospital/Brown Medical School. Training in basic and clinical immunology of HIV infection, measurement of adherence and psychosocial variables associated with adherence, statistics/research methods, and cognitive sequelae of HIV infection will be obtained through coursework, directed readings, and completion of the research study. The research component will examine the efficacy of a compensatory strategy to support adherence to HIV treatment. A total of 125 HIV-positive individuals will be recruited and adherence will be monitored during a four-week baseline period. Immunological status, psychosocial variables associated with behavior change, and cognitive function will be examined at baseline. The participants will then be randomized into one of two treatment arms. One group will receive standard clinical care (SC). The second group will receive standard care and a pre-programmed wristwatch that will deliver a mnemonic aid (MA) to facilitate HAART dosing. Adherence will be measured using electronic monitoring and pill count. Immunological status, psychosocial variables, cognitive function, and adherence will be re-examined after six months and again one month after the end of the trial. Analyses will determine the efficacy of the MA to support adherence to HAART. Regression analyses will be conducted to determine the degree to which adherence is associated with CD4/CD8 cell count, plasma viral load, and cognitive function. The relationship between psychosocial factors associated with behavior change and adherence will be examined in both treatment groups. The results will provide important insights regarding the clinical care of patients with HIV. The study will also provide the applicant the opportunity to implement research skills obtained throughout the training period of the award.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Mentored Patient-Oriented Research Career Development Award (K23)
Project #
7K23MH065857-06
Application #
7086834
Study Section
Special Emphasis Panel (ZRG1-AARR-8 (01))
Program Officer
Stirratt, Michael J
Project Start
2002-06-01
Project End
2008-05-31
Budget Start
2006-06-01
Budget End
2008-05-31
Support Year
6
Fiscal Year
2006
Total Cost
$152,024
Indirect Cost
Name
University of Missouri-St. Louis
Department
Psychology
Type
Schools of Arts and Sciences
DUNS #
804883825
City
Saint Louis
State
MO
Country
United States
Zip Code
63121
Ortega, Mario; Heaps, Jodi M; Joska, John et al. (2013) HIV clades B and C are associated with reduced brain volumetrics. J Neurovirol 19:479-87
Heaps, Jodi M; Joska, John; Hoare, Jackie et al. (2012) Neuroimaging markers of human immunodeficiency virus infection in South Africa. J Neurovirol 18:151-6
Tate, David F; Delong, Allison; McCaffrey, Daniel E et al. (2011) Recent clinical history and cognitive dysfunction for attention and executive function among human immunodeficiency virus-infected patients. Arch Clin Neuropsychol 26:614-23
Tate, David F; Sampat, Mehul; Harezlak, Jaroslaw et al. (2011) Regional areas and widths of the midsagittal corpus callosum among HIV-infected patients on stable antiretroviral therapies. J Neurovirol 17:368-79
Tate, David F; Conley, Jared; Paul, Robert H et al. (2010) Quantitative diffusion tensor imaging tractography metrics are associated with cognitive performance among HIV-infected patients. Brain Imaging Behav 4:68-79
Paul, Robert; Grieve, Stuart M; Chaudary, Bilal et al. (2009) Relative contributions of the cerebellar vermis and prefrontal lobe volumes on cognitive function across the adult lifespan. Neurobiol Aging 30:457-65
Haley, Andreana P; Hoth, Karin F; Gunstad, John et al. (2009) Subjective cognitive complaints relate to white matter hyperintensities and future cognitive decline in patients with cardiovascular disease. Am J Geriatr Psychiatry 17:976-85
Valcour, V G; Shiramizu, B T; Sithinamsuwan, P et al. (2009) HIV DNA and cognition in a Thai longitudinal HAART initiation cohort: the SEARCH 001 Cohort Study. Neurology 72:992-8
Hoth, Karin F; Haley, Andreana P; Gunstad, John et al. (2008) Elevated C-reactive protein is related to cognitive decline in older adults with cardiovascular disease. J Am Geriatr Soc 56:1898-903
Paul, Robert H; Ernst, Thomas; Brickman, Adam M et al. (2008) Relative sensitivity of magnetic resonance spectroscopy and quantitative magnetic resonance imaging to cognitive function among nondemented individuals infected with HIV. J Int Neuropsychol Soc 14:725-33

Showing the most recent 10 out of 26 publications