International NeuroAIDS: Scientific and Methodological Research Challenges

国际神经艾滋病：科学和方法研究的挑战

• 批准号: 7334085
• 负责人: John ALLEN MCCUTCHAN
• 金额: $ 5.41万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN DIEGO
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-06-14 至 2012-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7334085
• 关键词: AIDS neuropathy; Acute; Address; Affect; Africa South of the Sahara; Anti-Retroviral Agents; Antiviral Therapy; Arts; Asia; Caucasians; Caucasoid Race; Cerebral Malaria; Cerebral Toxoplasmosis; Clinical; Clinical Management; Consensus; Country; Cryptococcal Meningitis; Developed Countries; Developing Countries; Diagnosis; Funding; Future; HIV; HIV Infections; HIV-1; Highly Active Antiretroviral Therapy; Human; Immune; Immunogenetics; Infection; International; Internet; Monograph; National Institute of Mental Health; Neurologic; Online Systems; Opportunistic Infections; P-30 composite resin; Patients; Penetration; Pharmacogenetics; Population; Printing; Publications; Research; Research Personnel; Resources; Series; Site; Syndrome; Technology; Training; Tuberculosis; Work; abstracting; improved; neuropsychological; neurotoxicity; programs; ranpirnase; reconstitution; virus genetics; virus host interaction

DESCRIPTION (provided by applicant): We propose a series of three meetings in the U.S. over five years to address scientific opportunities and perceived methodological hurdles to international neuroAIDS research in resource-limited settings. The focus of neuroAIDS research increasingly hinges on questions regarding host-virus interactions and impact of HAART. While the majority of HIV research has taken place in Western countries, HIV infection is most prevalent and least controlled in resource-limited settings such as sub-Saharan Africa, and East and South Asia. Findings from studies conducted in Western countries that derive mainly from work on HIV-1 Clade B infection and Caucasian populations therefore may not be generalizable to HIV clades and human populations internationally. Additionally, now that ART is increasingly available internationally, improved management of acute neurologic opportunistic infections is critical to short-term survival, which in turn enables patients to initiate long-term ART. In the international sphere, three critical scientific priorities are as follows: 1. Opportunistic Infections: Problems persist in the management of neurologic opportunistic infections that are: a) unique to developing countries (e.g. cerebral malaria), and b) difficult to diagnose and treat in resource-limited settings (e.g. tuberculosis and cryptococcal meningitis, cerebral toxoplasmosis). 2. Antiviral Therapy: Implementation of HAART on a massive scale by the U.S. PEPFAR and the U.N. Global Fund programs in resource-limited settings has presented problems of neurotoxicity, CNS penetration, and CNS immune-reconstitution syndromes that require study. 3. Host and Viral Genetics: The immunogenetic and pharmacogenetic diversity of affected human populations and of HIV (clades) may modify the manifestations of neuroAIDS. The first of these scientific meetings will examine methodological problems of neurological assessment in developing countries. Meeting 2 will address the changing impact on neuroAIDS of dissemination of ART, and meeting 3 will review progress and propose future agendas for international neuroAIDS research. Three training sessions for international investigators will be held in conjunction with these meetings, sponsored by the collaborating NIMH P-30 NeuroAIDS Centers. Through the proposed meetings, we aim to a) identify and correct technical barriers to international neuroAIDS research and facilitate deployment of state-of-the-art neuropsychological research technologies, b) examine differences in developed and developing countries in the scientific and clinical issues of neuroAIDS, c) improve clinical management of neuroAIDS, d) examine the impact of anti-retroviral therapy on neuroAIDS in developing countries, and e) set agendas for future neuroAIDS research in resource-limited settings. We will disseminate abstracts and discussions from these meetings via public access to meeting presentations on our web site, presentation of meeting summary at other scientific meetings, and publication of consensus monograph in open-access print and web-based forms.

描述（由申请人提供）：我们在五年内提出了一系列在美国的三场会议，以解决科学机会和感知的方法论障碍，以解决资源有限的环境中的国际神经辅助研究。神经辅助研究的重点越来越多地取决于有关宿主病毒相互作用和HAART影响的问题。尽管大多数艾滋病毒研究都在西方国家进行，但在撒哈拉以南非洲和东亚和南亚等资源有限的环境中，艾滋病毒感染最为普遍，最不受欢迎。因此，在西方国家进行的研究的结果主要是从HIV-1进化枝的感染和高加索人口进行的研究中，因此在国际上可能无法推广到HIV进化枝和人口。此外，既然ART在国际上越来越多地可用，那么急性神经系统感染的治疗对短期生存至关重要，这反过来又使患者能够启动长期艺术。在国际领域，三个关键的科学重点如下：1。机会性感染：问题持续存在于神经系统的机会性感染的管理中：a）是：a）发展中国家所独有的（例如脑疟疾），b）难以诊断和治疗资源受限的环境（例如结核病和冷冻症状症状症状症状症状症状，cere; 2。抗病毒疗法：美国PEPFAR大规模实施HAART和在资源有限的环境中的联合国全球基金计划的实施提出了神经毒性，中枢神经系统渗透以及CNS免疫统治综合症的问题。 3。宿主和病毒遗传学：受影响的人群和HIV（进化枝）的免疫遗传和药物遗传学多样性可能会改变神经辅助的表现。这些科学会议中的第一次将研究发展中国家神经评估的方法论问题。会议2将解决对艺术传播神经辅助的影响不断变化的影响，而会议3将审查进度，并提出未来的国际神经辅助研究议程。由合作的NIMH P-30 Neuroaids中心赞助的这些会议将对国际调查人员进行三场培训课程。 Through the proposed meetings, we aim to a) identify and correct technical barriers to international neuroAIDS research and facilitate deployment of state-of-the-art neuropsychological research technologies, b) examine differences in developed and developing countries in the scientific and clinical issues of neuroAIDS, c) improve clinical management of neuroAIDS, d) examine the impact of anti-retroviral therapy on neuroAIDS in developing countries, and e) set在资源有限的设置中为未来神经辅助研究的议程。我们将通过公开访问我们的网站上的会议演示，在其他科学会议上的会议摘要以及以开放式印刷和基于Web的形式发布共识专着，从而传播这些会议中的摘要和讨论。