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HIV Aging & Brain New research at University of Nebraska: "HIV infection of the nervous system leads to inflammatory responses, changes in brain cells, and damage to neurons. This is the first study to show such neuronal loss during initial stages of HIV infection in a mouse model."
  Meds helping HIV patients live longer
March 30, 2011
By Rick Ruggles
HIV patients are living longer because of effective medications, but many are aging more rapidly than they should.
They have memory and learning problems as well as premature heart disease, bone disease and overall frailty.
A University of Nebraska Medical Center scientist has received a $9 million federal grant to seek the cause and search for ways to diagnose and treat the early onset of brain disease among patients with HIV.
Dr. Howard Fox, a UNMC researcher and medical doctor, said that by the year 2015, more than half of the people with HIV will be 50 years of age and older.
In some cases, he said, doctors and scientists have observed through MRI scans and other ways that HIV patients' brains age quicker, so that a 50-year-old patient's brain might look and function like that of a person 60 years of age or older.
What's causing this? "We really don't know," Fox said.
The federal Centers for Disease Control and Prevention estimates that 1.1 million Americans have HIV or AIDS, which is a late stage of HIV. HIV stands for human immunodeficiency virus, AIDS for acquired immune deficiency syndrome.
Fox said it could be the ever-present virus itself that causes the brain to age. Or it could be the interaction of various medications the patients take. Or it could be the fact that the patients' immune systems always are smoldering that has an adverse effect on the brain.
Dr. Susan Swindells, who will also conduct research in this study, said that while the project will focus largely on the brain, HIV patients experience premature heart disease and other problems. She said HIV causes chronic inflammation and stress, and patients' bodily systems are always on the alert against the virus.
"That's not a healthy situation to be in, and HIV promotes that," said Swindells, director of the UNMC HIV Clinic. But scientists don't know specifically what causes the premature aging and deterioration. "We really are struggling with this," she said.
Pedro R. Mancillas Jr. exercises his body by mowing the lawn, walking and riding his bicycle, and his mind by reading. Mancillas, 54, said he was diagnosed with AIDS 20 years ago but has generally held it at bay through medication.
Although he is doing comparatively well, Mancillas said he believes it's true that HIV/AIDS patients age faster. "Every single one of us that I know gets tired fast," he said.
Mancillas has been on effective medications since they began to be utilized for HIV/AIDS patients 15 years ago. "I have a real positive attitude," he said. "We're really lucky, people with HIV, that we have this medicine to help us."
Fox said HIV/AIDS patients died within seven to 15 years in the late 1980s and early 1990s. But with new combinations of drugs that were introduced about 15 years ago, patients now live 20 years and more, and do well.
Dr. Jeymohan Joseph of the National Institute of Mental Health said that because HIV patients are living longer, "there is a critical need for research" into their brain disorders.
Among other things, Fox will seek proteins and other indicators that doctors could test for to predict whether an HIV patient will suffer a brain disorder or whether one is in its early stages. Dr. Howard Gendelman, a UNMC scientist, will strive to target drugs to brain cells affected by a disorder.
Fox said the research may enable UNMC to find strategies for diagnosis and treatment for the aging population in general.
Early Brain Effects of HIV in Mouse Model
ScienceDaily (Mar. 2, 2011) - A new mouse model closely resembles how the human body reacts to early HIV infection and is shedding light on nerve cell damage related to the disease, according to researchers funded by the National Institutes of Health.
The study in the Journal of Neuroscience demonstrates that HIV infection of the nervous system leads to inflammatory responses, changes in brain cells, and damage to neurons. This is the first study to show such neuronal loss during initial stages of HIV infection in a mouse model.
The study was conducted by a team of scientists from the University of Nebraska Medical Center, Omaha, and the University of Rochester Medical Center, N.Y. It was supported by the National Institute on Drug Abuse (NIDA), the National Institute of Neurological Disorders and Stroke, the National Institute of Mental Health, and the National Center for Research Resources.
"This research breakthrough should help us move forward in learning more about how HIV affects important brain functioning in its initial stages, which in turn could lead us to better treatments that can be used early in the disease process," said Dr. Nora D. Volkow, director of NIDA.
"The work contained within this study is the culmination of a 20-year quest to develop a rodent model of the primary neurological complications of HIV infection in humans," said Dr. Howard Gendelman, one of the primary study authors. "Previously, the rhesus macaque was the only animal model for the study of early stages of HIV infection. However, its use was limited due to expense and issues with generalizing results across species. Relevant rodent models that mimic human disease have been sorely needed."
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