# Effects of the neural and inflammatory response to stress on cerebrovascular risk in HIV infection

> **NIH NIH K23** · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · 2020 · $200,052

## Abstract

PROJECT SUMMARY
This is an application for a K23 award for Dr. Felicia Chow, who is establishing herself as an investigator in
patient-oriented clinical research at the intersection of HIV and cerebrovascular disease. This K23 award will
provide Dr. Chow with the support necessary to develop new research skills and attain practical and
conceptual expertise in 4 key areas: 1) brain and vascular FDG-PET imaging, 2) mechanisms and
measurement of psychological stress, 3) advanced statistical techniques for observational data, and 4) design,
conduct and analysis of clinical trials. Dr. Chow has assembled an interdisciplinary team of mentors (Dr.
Priscilla Hsue, an expert in the role of inflammation and endothelial dysfunction in the pathogenesis of
cardiovascular disease in HIV; Dr. Gil Rabinovici, an expert in use of multimodal brain imaging, including novel
brain PET techniques, to improve diagnosis of dementia; Dr. Elissa Epel, an expert on measurement of stress
and its effects on inflammation and cardiometabolic disease; Dr. Frederick Hecht, an expert on stress and
mindfulness-based interventions in HIV; Dr. Peter Bacchetti, an expert on statistical approaches to analyzing
observational HIV data), who will guide her research and career development. This multi-layered mentorship
structure, embedded in a highly collaborative training environment, will be critical to her development into an
independent investigator, with the ultimate goal of optimizing cerebrovascular health in people living with HIV.
With the evolution of HIV infection into a chronic, treatable disease, people with HIV face excess risk of several
non-AIDS-related complications, including stroke. Traditional vascular risk factors (e.g., hypertension, smoking)
account for only a portion of excess cerebrovascular risk in HIV. This proposal will investigate the role of
psychological stress, which is highly prevalent in people with HIV, in HIV-associated cerebrovascular risk. Dr.
Chow hypothesizes that psychological stress activates pro-inflammatory pathways that contribute to elevated
cerebrovascular risk in HIV. She will leverage the research infrastructure of two NIH-funded studies to evaluate
the association of stress with the neural inflammatory pathway (i.e., amygdala activity, immune activation,
inflammatory cytokines) in Aim 1 and with cerebrovascular risk markers (i.e., carotid arterial inflammation on
FDG-PET and cerebral vasoreactivity by transcranial Doppler ultrasound) in Aim 2 in a cross-section of people
with well-controlled HIV. In Aim 3, she will pilot a controlled trial of a mindfulness-based stress reduction
intervention in a subset of high-stress individuals with HIV to gain preliminary insight into the impact of
mindfulness on the neural inflammatory pathway and on cerebrovascular risk markers. This proposal is a
crucial step toward uncovering the contribution of psychological stress to cerebrovascular risk in people with
HIV and developing a larger randomized contro...

## Key facts

- **NIH application ID:** 9991945
- **Project number:** 5K23NS105575-04
- **Recipient organization:** UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
- **Principal Investigator:** Felicia C. Chow
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $200,052
- **Award type:** 5
- **Project period:** 2017-09-30 → 2022-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9991945

## Citation

> US National Institutes of Health, RePORTER application 9991945, Effects of the neural and inflammatory response to stress on cerebrovascular risk in HIV infection (5K23NS105575-04). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/9991945. Licensed CC0.

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