This subproject is one of many research subprojects utilizing theresources provided by a Center grant funded by NIH/NCRR. The subproject andinvestigator (PI) may have received primary funding from another NIH source,and thus could be represented in other CRISP entries. The institution listed isfor the Center, which is not necessarily the institution for the investigator.The California NeuroAIDS Tissue Network (CNTN) is a consortium of five (5) California medical centers (UC San Diego, UC San Francisco, UC Irvine, USC/LA County, and Cedars/UC Los Angeles) which proposes to collect neuropsychiatric data (prior to death) and neurologic specimens (at autopsy) from 300 AIDS patients and 75 controls over five years (controls are not enrolled and followed while alive). The specimens will be stored in a repository for use in future studies designed to understand the impact of HIV infection on the nervous system.The UCI component is designed to identify, recruit, enroll, and assess a cohort of 30 AIDS patients with life expectancies of less than one year. The cohort will be maintained at 30 patients throughout the five-year study by replacing those who die or drop out of the study. About 6 patients will be autopsied each year. Over 5 years, an additional 5-10 autopsies will be performed on patients with AIDS and neurologic diseases without prior clinical assessment.The principal investigator and a neurologist will oversee a research nurse who will perform the assessments in life. A neuropathologist and laboratory assistant will perform the neurologic autopsy in collaboration with the General Autopsy Service. The UCI investigators will transmit data and specimens to the CNTN Administrative and Data Center and Brain Bank at UCSD, which will provide data management, tissue storage, coordination among network sites, and quality control of all aspects of the project through training and monitoring.Participants will be recruited from the UCI Medical Center clinics and other local clinics and private practices. Taken together, these sites provide services to about 1200 patients with AIDS throughout Orange County. Patients will undergo structured medical, neurologic, neuropsychologic, immunologic, and virologic assessment every 6 months until they die. Having pre-consented, they will be transferred to UCI Medical Center for general and neurologic autopsy within 12 hours of death. Using a standardized protocol, half of the brain will be cooled and sent via courier to the Central CNTN Brain Bank along with post-mortem CSF, blood, and other tissue samples. The remaining hemisphere will be sampled and examined for histopathology at UCI after formalin fixation and the remainder shipped to the Central Bank several weeks later.
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