Vascular contributions to cognitive impairments and dementia (VCID) among people living with HIV in the country of Georgia

格鲁吉亚艾滋病毒感染者的血管对认知障碍和痴呆症 (VCID) 的影响

• 批准号: 10648790
• 负责人: Jack A DeHovitz
• 金额: $ 10万
• 依托单位: PARTNERSHIP FOR RESEARCH/ACTION/HEALTH
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-04-22 至 2024-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10648790
• 关键词: Acquired Immunodeficiency Syndrome; Address; Adverse effects; Age; Age-Years; Aging; Alcohol consumption; Blood Vessels; CD4 Lymphocyte Count; Central Asia; Cerebrovascular Disorders; Clinical; Continuity of Patient Care; Country; Dementia; Development; Disease; Elderly; European; Event; Future; Gender; Goals; Grant; HIV; HIV Infections; Hepatitis C co-infection; Hyperlipidemia; Hypertension; Impaired cognition; Infection; Knowledge; Measures; Non-Insulin-Dependent Diabetes Mellitus; Obesity; Observational Study; Outcome; Participant; Peripheral; Persons; Pilot Projects; Prevalence; Process; Recording of previous events; Research; Research Personnel; Research Project Grants; Research Training; Risk; Risk Factors; Severities; Standardization; Stratification; Stroke; Substance abuse problem; Training; Viral Load result; age group; anxiety symptoms; blood-based biomarker; brain health; cigarette smoking; clinically relevant; cognitive performance; dementia risk; depressive symptoms; injection drug use; innovation; investigator training; prospective; sex; sociodemographics; therapy development; vascular cognitive impairment and dementia

Limited knowledge exists about vascular contributions to cognitive impairments and dementia (VCID) among PLWH or older adults without infection in the Eastern European and Central Asia (EECA) region including Georgia. The intersection of VCID with the HIV care continuum has never been estimated in Georgia and the EECA, and not evaluated among PLWH who are living to older ‘at risk’ ages. To mitigate adverse effects of VCID among PLWH, the prevalence of VCID and other aging-related risk factors must be estimated and characterized across the HIV care continuum. This application is a supplement to Fogarty HIV Research Training Grant (1D43TW011532; Strategic Training Partnership to End AIDS in Georgia). We propose to address the surging ‘HIV + noncommunicable disease (NCD)’ care continuum in Georgia. Early Stage Investigator (ESI) training will be operationalized via: Aim 1. Advanced didactic training in HIV-aging, VCID measures, and brain health outcomes; and Aim 2. Hands- on training in research project development, implementation and analysis via conducting a cross-sectional pilot study of 150 PLWH age >40 years. Among these participants, the goals of the pilot study are to: Aim 2.a. Characterize sociodemographic and HIV (e.g., HIV viral load, CD4+ count) factors; Aim 2.b. Estimate the prevalence of VCID and brain health using pilot study measures. VCID include obesity, hypertension, Type 2 diabetes, and hyperlipidemias; history of cardio- and peripheral vascular events; cigarette smoking; alcohol use; and substance abuse. Brain health outcomes include cognitive performance and impairment, severity and clinically-relevant depression and anxiety symptoms, and history of cerebrovascular disease and stroke. Aim 2.c. Evaluate VCID risk and history with stratification by HIV severity (viral load and CD4+ count), HCV coinfection (yes/no), injection drug use (yes/no), 10-year age group, and sex and gender. This innovative pilot study is the first in Georgia and the EECA region among aging PLWH that uses standardized and validated clinical and blood-based biomarker approaches. Our results will inform development of interventions to reduce VCID and adverse brain health outcomes related to the HIV+NCD care continuum among PLWH; and prospective observational studies to compare aging processes between PLWH and people without HIV infection. These future deliverables will be achieved through HIV research capacity building of one Georgian ESI, a recent doctoral graduate, who will receive advanced didactic and hands-on training in the development of a strategic skillset.

关于血管对认知障碍和痴呆症的影响的知识有限 (VCID) 在东欧和中欧地区的 PLWH 或未感染的老年人中 亚洲 (EECA) 地区，包括格鲁吉亚 VCID 与 HIV 护理连续体的交叉点。 从未在乔治亚州和欧洲经济区进行过估计，也未在感染者中进行过评估 为了减轻 VCID 对 PLWH 的不利影响， 必须估计和描述 VCID 和其他与衰老相关的危险因素的患病率 该应用程序是 Fogarty HIV Research 的补充。 培训补助金（1D43TW011532；格鲁吉亚消灭艾滋病战略培训伙伴关系）。 我们建议解决不断增长的“艾滋病毒+非传染性疾病（NCD）”护理连续问题 乔治亚州的早期研究者 (ESI) 培训将通过以下方式实施： 目标 1. 高级 HIV 衰老、VCID 测量和大脑健康结果方面的教学培训；以及目标 2。 通过开展研究项目开发、实施和分析方面的培训 对 150 名年龄 >40 岁的 PLWH 参与者进行的横断面试点研究，目标是。 试点研究的目标是： 目标 2.a 描述社会人口特征和 HIV 特征（例如 HIV 病毒载量、 CD4+ 计数）因素；目标 2.b. 使用试点估计 VCID 的患病率和大脑健康状况 研究措施包括肥胖、高血压、2 型糖尿病和高脂血症； 心血管和外周血管事件史；以及 药物滥用对大脑健康的影响包括表现和损伤， 严重程度和临床相关的抑郁和焦虑症状，以及病史 目标 2.c. 通过分层评估 VCID 风险和病史。 按 HIV 严重程度（病毒载量和 CD4+ 计数）、HCV 合并感染（是/否）、注射吸毒情况分类 （是/否）、10 岁年龄组以及性别和性别 这项创新试点研究是第一项。 乔治亚州和欧洲经济区 (EECA) 地区的老龄化 PLWH 使用标准化和经过验证的方法 我们的结果将为临床和基于血液的生物标志物方法的开发提供信息。 减少与 HIV+NCD 护理相关的 VCID 和不良脑健康结果的干预措施 PLWH 的连续体；以及比较衰老过程的前瞻性观察研究 这些未来的成果将得以实现。 通过对格鲁吉亚 ESI 的一位新近博士毕业生进行艾滋病毒研究能力建设，他 将接受发展战略技能的高级教学和实践培训。