HIV-associated Neuropathy: Ethnic Disparities and Pathogenesis

HIV 相关神经病：种族差异和发病机制

• 批准号: 7910480
• 负责人: Jessica Robinson-Papp
• 金额: $ 17.01万
• 依托单位: ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-08-15 至 2014-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7910480
• 关键词: Accounting; Affect; Anti-Retroviral Agents; Autopsy; Biopsy; Biopsy Specimen; Brain; Characteristics; Clinical; Clinical Treatment; Clinical Trials; Complication; Data; Distal; Ethnic Origin; Ethnic group; FDA approved; Goals; HIV; HIV Infections; HIV Seropositivity; Hypersensitivity skin testing; Knowledge; Measures; Minority; National NeuroAids Tissue Consortium; Neural Conduction; Neurologic; Neuropathy; Neurosciences; Pain; Pathogenesis; Pathologic; Pathology; Patients; Peripheral Nerves; Pharmaceutical Preparations; Polyneuropathy; Population; Prevalence; Quality of life; Race; Recruitment Activity; Reporting; Research; Research Personnel; Sensory; Signs and Symptoms; Skin; Specimen; Symptoms; Testing; Woman; advanced disease; autonomic neuropathy; effective therapy; experience; immunopathology; instrument; literacy; painful neuropathy; programs; public health relevance; racial and ethnic; racial/ethnic difference; research study

DESCRIPTION (provided by applicant): Minorities and women now account for a disproportionate number of new HIV infections. Neuropathy is the most common neurologic complication of HIV, occurring in up to 60% of patients with advanced disease. Neuropathy is commonly painful and can have a significant negative impact on quality of life. Recent clinical trials of treatment for neuropathic pain related to HIV have had disappointing results, raising the question of whether the study medications truly lack efficacy, or if the instruments used to measure pain were poorly suited to the population under study. Pilot data suggest there may be racial and ethnic differences in clinical manifestations of HIV-associated neuropathy, including pain. The goal of this project is to better define these differences and to explore their neuro-biologic and socio-cultural underpinnings. Specific aims are: 1. To determine whether there are differences between racial and ethnic groups in clinical and neurophysiologic features of HIV-associated neuropathy 2. To determine if commonly used pain scales adequately reflect the pain experience of minority, low-literacy patients with HIV-associated distal sensory polyneuropathy (HIV-DSP) 3. To determine whether autonomic neuropathy (AN) is prevalent in HIV-positive minorities 4. To determine whether the characteristic peripheral nerve and skin biopsy pathology of HIV-DSP in the HAART-era varies with race or ethnicity Retrospective analyses will be performed on data collected by the National NeuroAIDS Tissue Consortium and the CNS HIV Antiretroviral Effects Research Study. Going forward, predominantly minority patients will be recruited for detailed neurologic assessment including: administration of pain and symptom scales; detailed neurologic assessment and quantification of deficits using validated instruments; neurophysiologic testing (nerve conduction studies, quantitative sensory testing and autonomic testing); and skin biopsy. Peripheral nerve pathology will be studied using autopsy specimens from the Manhattan HIV Brain Bank. PUBLIC HEALTH RELEVANCE: Neuropathy is a common complication of HIV which significantly reduces quality of life, and for which there is no FDA-approved treatment. HIV now disproportionately affects minorities, so if effective treatments for neuropathy are to be developed, more information is needed about its clinical and pathologic manifestations in these populations, including the reporting of pain.

描述（由申请人提供）：少数民族和妇女现在占新的艾滋病毒感染数量不成比例。神经病是HIV最常见的神经系统并发症，在多达60％的晚期疾病患者中发生。神经病通常很痛苦，可能会对生活质量产生重大的负面影响。与HIV相关的神经性疼痛治疗治疗的最新临床试验令人失望，提出了一个问题，即研究药物是否真正缺乏疗效，或者用于测量疼痛的仪器是否不适合研究中的人群。试验数据表明，在包括疼痛在内的HIV相关神经病的临床表现中可能存在种族和种族差异。该项目的目的是更好地定义这些差异，并探索其神经生物学和社会文化的基础。具体目的是：1。确定与HIV相关神经病的临床和神经生理特征之间的种族和族裔之间是否存在差异。 HIV阳性少数族裔4。确定HAART时代的HIV-DSP的特征性周围神经和皮肤活检病理学是否随种族或种族回顾性分析而变化，该分析将对国家神经辅助协会收集的数据进行，并在CNS HIV HIV抗逆转录病毒效应研究中进行。展望未来，将主要招募少数族裔患者进行详细的神经系统评估，包括：疼痛和症状量表的给药；使用经过验证的工具对缺陷进行详细的神经系统评估和量化；神经生理测试（神经传导研究，定量感觉测试和自主神经测试）；和皮肤活检。将使用曼哈顿HIV脑库的尸检标本研究周围神经病理学。 公共卫生相关性：神经病是艾滋病毒的常见并发症，可显着降低生活质量，并且没有FDA批准的治疗方法。现在，艾滋病毒对少数族裔的影响不成比例，因此，如果要开发有效的神经病治疗方法，则需要更多有关其这些人群中其临床和病理表现的信息，包括疼痛的报告。