The HNRC and its International Core, in collaboration with NIMH staff and the P-30 neuroAIDS Centers at Scripps Research Institute and Johns Hopkins University, will convene three (3) meetings to address methodological hurdles and scientific opportunities for neuroAIDS research in resource-limited, international settings. To maximize the impact of the proposed meetings, three (3) adjunctive training conferences will be appended to these meetings to increase research capacity in international settings.
- October 28-29, 2007 (UCSD, La Jolla, California): 1st Conference on Methods in International NeuroAIDS Research
- May 31 - June 2, 2009 (UCSD and JHU, Miami Beach, Florida): 2nd Conference on Methods in International NeuroAIDS Research
- July 14-16, 2011 (UCSD and JHU, Frascati, Italy): 3rd Conference on Methods in International NeuroAIDS Research
The focus of neuroAIDS research increasingly hinges on questions regarding host-virus interactions and impact of HAART. While the majority of HIV research has taken place in Western countries, the virus itself is most prevalent and least-controlled in resource-limited settings such as sub-Saharan Africa, and East and South Asia. Findings from studies conducted in Western countries that derive mainly from work on HIV-1 Clade B infection and Caucasian populations therefore may not be generalizable to HIV clades and human populations internationally. Additionally, now that ART is increasingly available internationally, improved management of acute neurologic opportunistic infections is critical to short-term survival which in turn enables patients to initiate long-term ART.
In the international sphere, three critical scientific priorities are listed below:
- Opportunistic Infections: Problems persist in the management of neurologic opportunistic infections that are: a) unique to developing countries (e.g. cerebral malaria), and b) difficult to diagnose and treat in resource-limited settings (e.g. tuberculous and cryptococcal meningitis, cerebral toxoplasmosis).
- Antiviral Therapy: Implementation of HAART on a massive scale by the U.S. PEPFAR and the U.N. Global Fund programs in resource-limited settings have presented problems of neurotoxicity, CNS penetration, and CNS immune-reconstitution syndromes that require study.
- Host and Viral Genetics: The immunogenetic and pharmacogenetic diversity of affected human populations and of HIV (clades) may modify the manifestations of neuroAIDS.
In service of these scientific aims we will focus on a number of methodological problems in developing countries, particularly but not exclusively in the first of our three proposed meetings. Examples of these are:
- Neuropsychological functioning
- Neuromedical diagnostics and staging
- Neuroimaging correlates of HIV-E & Opportunistic Infections
- Neuropathological diagnosis of HIV-E & OIs
- Immunogenetic determinants of clinical manifestations and progression
- Immunopharmacologic determinants of responses to therapy