# Immunologic Profiles of Distinct Cognitive Trajectories in Adults  with Perinatal HIV

> **NIH NIH K23** · UNIVERSITY OF WASHINGTON · 2020 · $179,076

## Abstract

Over 60,000 young adults are living with HIV in the US today, many of whom acquired HIV at birth.
This group of adults with perinatally acquired HIV (pHIV) has not seen improvements in the prevalence of
HIV- related co-morbidities, including poor cognitive outcomes. Despite this trend, little is known about the
prognosis and pathogenesis of pHIV-related cognitive impairment in adulthood. Cognitive dysfunction
occurs in up to half of individuals living with HIV, and is directly associated with immune activation in
adults with horizontally acquired HIV (hHIV). In contrast, CD8+ T-cell and monocyte activation in our
cohort of children with pHIV in Southeast Asia correlates with better cognitive scores suggesting an
adapted immune-host response in those who are long-term survivors of pHIV. This adapted state has not
been well studied. The goal of our proposed study is to address key gaps in our understanding of
1) cognitive trajectories and 2) biomarkers of cognitive resilience in adults with pHIV, through a
recently initiated longitudinal cohort study of adults with pHIV in Connecticut. We will evaluate 1)
cognitive performance and 2) interactions between peripheral and cerebrospinal fluid (CSF) immunologic
markers, neuroimaging and cognition using a novel analytic method, group based trajectory modeling.
This study will determine the prognosis of cognitive impairment and further characterize the biologic
underpinnings of cognitive resilience as potential neuroprotective targets in adults with pHIV.
 The candidate is a pediatric neurologist with specialized training in neuro-infectious diseases. Dr.
Patel is committed to improving our understanding of the pathogenesis of and treatment for poor
neurologic outcomes following pHIV. The proposal will capitalize on Dr. Patel's prior training and
mentored research experience in group based trajectory analysis of longitudinal cognitive data in
children with pHIV, while enabling her to build expertise in 1) flow cytometry methods and
analyses, 2) utilizing diffusion tensor imaging as a research tool, and 3) dual trajectory analysis, a
complex modeling technique to assess contemporaneous changes in longitudinally acquired
biomarker and cognitive data. Dr. Patel has assembled a mentorship committee comprised of leaders
in the pathogenesis of neurologic injury in adults with hHIV (Serena Spudich, MD, primary mentor),
biomarkers of disease progression in pHIV (Elijah Paintsil, MBChB, co-mentor), and biostatistics and
imaging markers of cognitive impairment in pHIV (Robert Paul, PhD, co-mentor). The knowledge and
experience gained from this proposal will allow Dr. Patel to successfully compete for R01 funding to
further evaluate the pathogenesis and prevention of pHIV-related neurologic morbidity. Her future R01
applications will focus on cerebral HIV compartmentalization in adults with pHIV and analyzing cellular
subsets identified in the proposed study as linked to cognitive resilience in CSF using mass cytome...

## Key facts

- **NIH application ID:** 10190661
- **Project number:** 7K23MH119914-02
- **Recipient organization:** UNIVERSITY OF WASHINGTON
- **Principal Investigator:** Payal Patel
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $179,076
- **Award type:** 7
- **Project period:** 2019-07-11 → 2024-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10190661

## Citation

> US National Institutes of Health, RePORTER application 10190661, Immunologic Profiles of Distinct Cognitive Trajectories in Adults  with Perinatal HIV (7K23MH119914-02). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10190661. Licensed CC0.

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