HIV-associated Neuropathy: Ethnic Disparities and Pathogenesis

HIV 相关神经病：种族差异和发病机制

基本信息

批准号：
8512818
负责人：
Jessica Robinson-Papp
金额：
$ 17.56万
依托单位：
ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
依托单位国家：
美国
项目类别：
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

项目摘要

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.

现在，少数族裔和妇女在新增艾滋病毒感染者中所占比例过高。神经病是 HIV 最常见的神经系统并发症，发生在高达 60% 的晚期疾病患者中。神经病通常会带来疼痛，并对生活质量产生重大负面影响。近期临床治疗与艾滋病相关的神经性疼痛的试验结果令人失望，提出了一个问题：研究药物是否确实缺乏疗效，或者用于测量疼痛的仪器是否很差适合所研究的人群。试点数据表明临床上可能存在种族和民族差异 HIV 相关神经病的表现，包括疼痛。该项目的目标是更好地定义这些差异并探索它们的神经生物学和社会文化基础。具体目标是： 1. 确定种族和民族之间在临床和治疗方面是否存在差异 HIV相关神经病的神经生理学特征 2. 确定常用的疼痛量表是否充分反映少数人的疼痛体验，患有 HIV 相关远端感觉多发性神经病 (HIV-DSP) 的低识字率患者 3. 确定自主神经病变 (AN) 在 HIV 阳性少数群体中是否普遍存在 4. 确定HIV-DSP的特征性周围神经和皮肤活检病理学特征是否存在 HAART 时代因种族或民族而异将对国家神经艾滋病组织联盟收集的数据进行回顾性分析和中枢神经系统艾滋病毒抗逆转录病毒作用研究。展望未来，主要是少数族裔患者被招募进行详细的神经系统评估，包括：疼痛和症状量表的管理；使用经过验证的仪器进行详细的神经系统评估和缺陷量化；神经生理学的测试（神经传导研究、定量感觉测试和自主测试）；和皮肤活检。将使用曼哈顿艾滋病毒脑库的尸检标本来研究周围神经病理学。

项目成果

期刊论文数量（11）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Amyloid neuropathies.

DOI：
10.1002/msj.21352
发表时间：
2012-11
期刊：
MOUNT SINAI JOURNAL OF MEDICINE
影响因子：
0
作者：
Shin, Susan C.;Robinson-Papp, Jessica
通讯作者：
Robinson-Papp, Jessica

Neuromuscular diseases associated with HIV-1 infection.

DOI：
10.1002/mus.21465
发表时间：
2009-12
期刊：
MUSCLE & NERVE
影响因子：
3.4
作者：
Robinson-Papp, Jessica;Simpson, David M.
通讯作者：
Simpson, David M.

Assessment of autonomic symptoms in a medically complex, urban patient population.

DOI：
10.1007/s10286-016-0384-4
发表时间：
2017-03
期刊：
Clinical autonomic research : official journal of the Clinical Autonomic Research Society
影响因子：
0
作者：
Robinson-Papp J;Sharma SK;George MC;Simpson DM
通讯作者：
Simpson DM

Trust and the ethics of chronic pain management in HIV.

艾滋病毒慢性疼痛管理的信任和伦理。