# Tracking HIV Infection & Alcohol Abuse CNS Comorbidity with Neuroimaging

> **NIH NIH U01** · SRI INTERNATIONAL · 2020 · $1,122,070

## Abstract

PROJECT SUMMARY ABSTRACT
 As the successfully treated population of Human Immunodeficiency Virus (HIV)-infected individuals
age, cognitive and health challenges of normal aging ensue, burdened by HIV, treatment side effects,
and high prevalence comorbidities, notably, Alcohol Use Disorder (ALC) and hepatitis C virus (HCV). The
aging brain is increasingly vulnerable to endogenous and exogenous insult which, coupled with HIV
infection, can lead to HIV-Associated Neurocognitive Disorder (HAND) and sensorimotor disturbances.
 Our goal is to explicate the role of aging in magnetic resonance (MR)-detectable HIV pathology in the
context of common comorbidities (ALC, HCV), while considering HIV-relevant variables (nutrition,
medication adherence and toxicity, liver integrity). As common HIV-associated comorbidities of ALC and
HCV may intensify inflammatory cascades and potentiate HIV pathology, a corollary aim is to consider
whether circulating markers of inflammation (microbial dislocation, monocyte-related immune activation,
peripheral cytokine elevations) corroborate proposed imaging markers of neuroinflammation.
 We will follow 140 participants from our existing cohort and recruit 100 new subjects, with a focus on
older HIV-infected individuals, using MR metrics consistent with our longitudinal database.
In keeping with the requirements of the RFA, we propose four specific aims:
 1. Investigate the cross-sectional and longitudinal pattern of brain and cognitive changes in terms of
 disease and age trajectories using quantitative MR imaging and neurocognitive measures.
 2. Identify factors that modify HIV disease trajectory, including age, sex, alcohol consumption, HCV
 and its treatment, nutrition, medication adherence and toxicity, and hepatic integrity. Exploratory
 factors include measures of depressive symptoms, fatigue, sleep quality, and impulsivity.
 3. Establish evidence for neuroinflammatory markers using free water DTI and brain metabolites
 quantified by magnetic resonance spectroscopy.
 4. Quantify the extent of postural instability and truncal tremor in relation to comorbid factors and
 normal or accelerated aging.
 Accomplishment of these aims will enhance understanding of factors contributing to age and disease-
related cognitive decline, sensorimotor problems, and neurodegeneration. Convergent evidence from
blood biomarkers (elevations in microbial dislocation, monocyte activation, and proinflammatory
cytokines), MRS metabolites [myo-Inositol (mI), choline-containing compounds (Cho), macromolecules
(MM09+Lip09] and glutathione (GSH)], and DTI metrics (free water) may provide initial support for a
constellation of in vivo markers of neuroinflammation.

## Key facts

- **NIH application ID:** 9990633
- **Project number:** 5U01AA017347-13
- **Recipient organization:** SRI INTERNATIONAL
- **Principal Investigator:** Adolf Pfefferbaum
- **Activity code:** U01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $1,122,070
- **Award type:** 5
- **Project period:** 2007-09-30 → 2023-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9990633

## Citation

> US National Institutes of Health, RePORTER application 9990633, Tracking HIV Infection & Alcohol Abuse CNS Comorbidity with Neuroimaging (5U01AA017347-13). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9990633. Licensed CC0.

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