# Effects of HIV, Cocaine, and Prolonged ART Use on Subclinical Cardiovascular Disease

> **NIH NIH U01** · UNIVERSITY OF MARYLAND BALTIMORE · 2020 · $1,624,176

## Abstract

As the age of people living with HIV has been rising steadily due to the success of antiretroviral therapy
(ART), and continued new infections, the number of people with HIV in the US is now 1.2 million and continues
to rise. Since most older adults living with HIV were infected as young adults or in middle age, long-term
effects of HIV and ART are now emerging. HIV/ART-associated comorbidities represent a major challenge for
HIV-infected individuals. Of noninfectious comorbidities, coronary artery disease (CAD) has become one of
leading causes of death among older people with HIV infection. In addition to CAD traditional risk factors, HIV
and ART, cocaine use has been shown to be associated with CAD. In 1999, we received the first NIH grant in
the US to investigate the effects of HIV and cocaine use on subclinical atherosclerosis, specifically HIV-
associated cardiovascular comorbidity. Since then, 4 NIDA-funded studies by this team were conducted and a
cohort of study participants, with/without HIV infection, with/without ART and with/without cocaine use, has
been established and followed in Baltimore, Maryland for 17 consecutive years. Pursuing the goal of examining
the individual and combined effects of HIV infection, long-term exposure to ART, chronic cocaine use, and
other factors on subclinical CAD, we found that cocaine use may induce/accelerate subclinical CAD and other
HIV-associated comorbidities. We recently identified several high priority research questions/hypotheses that
deserve to be explored thorough collaborations with other investigators: (1) coronary plaque volume may be
more sensitive to quantify factors associated with coronary plaque burden, (2) telomere length may be
associated with HIV, cocaine use and aging, (3) Troponin T may be a maker for the degree of coronary plaque
burden, and (4) homocysteine may be a potentially useful biomarker for HIV/cocaine associated comorbidities.
The central objective for this U01 is to further examine whether and how cocaine use influences the HIV/ART-
associated CAD and other comorbidities. The specific aims of this proposed study are: (1) to maintain and
expand our existing cohort involving HIV/ART and cocaine-associated cardiovascular and other comorbidities
as a platform for high priority research and as a platform for other scientific collaborations; (2) to examine
longitudinally the effects of HIV, chronic cocaine use, and prolonged ART exposure on the presence,
development and progression of CCTA-defined subclinical/clinical CAD, (3) to investigate whether cocaine use
exacerbates the HIV-associated decline in cognitive function in HIV-infected cocaine users, (4) to investigate
whether HIV and cocaine are associated with telomere shortening, and (5) to examine interrelationships
between homocysteine (Hcy) and HIV/ART/cocaine-associated comorbidities. All the hypotheses proposed in
this application have not been tested and are crucial to the scientific field of HIV/AIDS and substanc...

## Key facts

- **NIH application ID:** 10148263
- **Project number:** 7U01DA040325-05
- **Recipient organization:** UNIVERSITY OF MARYLAND BALTIMORE
- **Principal Investigator:** SHENGHAN LAI
- **Activity code:** U01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $1,624,176
- **Award type:** 7
- **Project period:** 2016-06-01 → 2023-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10148263

## Citation

> US National Institutes of Health, RePORTER application 10148263, Effects of HIV, Cocaine, and Prolonged ART Use on Subclinical Cardiovascular Disease (7U01DA040325-05). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10148263. Licensed CC0.

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