Despite effective antiretrovirals (ARVs), central nervous system (CNS) dysfunction persists in people with HIV (PWH). CNS dysfunction encompasses not only neurocognitive impairment (NCI) but also mental health disorders including major depressive and anxiety disorders. At present, we remain uncertain of the etiology of CNS dysfunction as well as the functional consequences. Consequently, we have been unsuccessful in developing interventions to improve neuropsychiatric signs and symptoms in HIV-infected individuals who are treated with ARVs. Toward improved care of those with HIV, the Office of AIDS Research has prioritized the study of CNS dysfunction and the numerous comorbidities which may have additive or synergistic effects on the CNS (e.g., vascular, metabolic, substance use) in PWH on ARVs who are virally suppressed. The CNS Dysfunction Scientific Working Group is a multidisciplinary team with interdisciplinary expertise in epidemiology, psychology, psychiatry, neurology, comparative and molecular biology, cognitive neuroscience, neuroimaging, immunology, bioinformatics, and mathematical modelling to better characterize people with HIV with CNS dysfunction and other comorbidities.
Within the CNS Dysfunction SWG, Dr. Jennifer Coughlin (Associate Professor, Dept. of Psychiatry with a joint appointment in Radiology) has expertise in molecular imaging of neuropsychiatric disease, Dr. Leah Rubin (Associate Professor, Dept. of Neurology with a joint appointment in Epidemiology) has expertise in the cognitive and mental health of people living with HIV, and Dr. Dionna Williams (Assistant Professor, Dept. of Molecular and Comparative Pathobiology) has expertise in the neuropathogenesis of HIV. Together Drs. Coughlin, Rubin, and Williams will lead this SWG. The CNS dysfunction SWG will facilitate interdisciplinary collaborations focusing on approaches to better understanding CNS dysfunction among people with HIV. We aim to:
Aim 1: Promote the growth of our diverse team through provision of resources and mentorship to young clinician and non-clinician investigators who have new interest in HIV research. We are particularly well-positioned to foster the success of those with interests in computational approaches to stratification and clinical prediction modeling, validation of biomarker targets for precision imaging, identification of new biomarkers (with informatics), and development of new precision techniques such as molecular-genetic imaging.
Aim 2: Facilitate the development and success of new protocols that generate new data (e.g., clinical, neuroimaging, biospecimens) or use existing and prospective clinical datasets such as the electronic health record (EHR), multi-domain neuropsychological and mental health data, biospecimen characteristics, and neuroimaging toward characterizing people with HIV with CNS dysfunction and comorbidities