# Defining the clinical utility of CSF biomarkers of neurodegeneration in HIV+ elders

> **NIH NIH K23** · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · 2020 · $198,882

## Abstract

ABSTRACT
This is an application for a K23 award for Dr. Joanna Hellmuth, a behavioral neurology fellow at the University
of California, San Francisco (UCSF) Memory and Aging Center (MAC). Dr. Hellmuth is establishing herself as
a junior investigator conducting patient-oriented clinical research in geriatric neuroHIV, including the
neuropathogenesis of HIV-Associated Neurocognitive Disorder (HAND) and approaches to accurately
diagnose, treat and prevent this condition. This K23 will provide Dr. Hellmuth with the resources and support
essential to accomplish the following goals: (1) to gain proficiency in cerebrospinal fluid (CSF) biomarker
analysis and methodologies; (2) to advance her understanding of the indicators of neurodegeneration,
including interpretation of cerebrospinal (CSF) neurodegenerative biomarkers and amyloid PET scans; (3) to
gain advanced skills in longitudinal neuroimaging techniques and statistical analyses addressing multivariable
and longitudinal modeling; and (5) primary mentorship in the operations of clinical research. To achieve these
goals, Dr. Hellmuth has assembled a mentoring team of a primary mentor, Dr. Victor Valcour (HIV-associated
cognitive disorders; multimodal neuroimaging in HIV; clinical research in geriatric neuroHIV); and two co-
mentors, Dr. Gil Rabinovici (multi-modal neuroimaging in Alzheimer’s disease (AD); biomarkers that improve
diagnostic accuracy of AD) and Dr. Henrik Zetterberg (clinical neurochemistry; CSF and plasma biomarkers for
the early diagnosis of neurodegenerative disorders, including AD).
The proposed research project addresses the diagnostic dilemma of how to accurately diagnose HIV+ elders
with cognitive impairment, as their age increases the risk for an Alzheimer’s disease (AD) diagnosis, however
the symptoms could reflect HIV-Associated Neurocognitive Disorder (HAND). Dr. Hellmuth will examine a
longitudinal panel of CSF biomarkers of AD, ones that are perturbed in some reports of HIV patients, in a
unique clinical sample: HIV+ elders with mild symptomatic cognitive impairment who have had AD
neuropathology ruled out by amyloid PET scan, and are virally suppressed with antiretroviral therapy. Through
this, she will establish the utility of these CSF AD biomarkers in HIV+ elders on treatment, explore the
associations between these CSF AD biomarkers and markers of persistent CSF immune activation, and see
how both AD and immune activation markers can predict accelerated brain atrophy in HAND. Dr. Hellmuth’s
K23 training will prepare her to conduct independent, clinical research in geriatric neuroHIV using CSF
biomarkers and neuroimaging, and will prepare her to successfully apply for an R01, and become a leader in
the field of geriatric neuroHIV.

## Key facts

- **NIH application ID:** 9971581
- **Project number:** 5K23MH114724-04
- **Recipient organization:** UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
- **Principal Investigator:** Joanna Hellmuth
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $198,882
- **Award type:** 5
- **Project period:** 2017-07-18 → 2022-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9971581

## Citation

> US National Institutes of Health, RePORTER application 9971581, Defining the clinical utility of CSF biomarkers of neurodegeneration in HIV+ elders (5K23MH114724-04). Retrieved via AI Analytics 2026-05-27 from https://api.ai-analytics.org/grant/nih/9971581. Licensed CC0.

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