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The Campbell Foundation has been a long-time funder of HIV-associated dementia research

HIV–associated neurocognitive disorder

News reports have surfaced in recent weeks of how those with HIV are now living long enough to develop Alzheimer’s disease. The good news in all of this is that we have been able to develop medications and treatments to keep those with HIV and AIDS alive for significantly longer than ever before.

The recent case making headlines involves a 71-year-old man with amyloid deposits in the brain that were detected by a PET scan. These deposits have been linked to Alzheimer’s disease. Until now, it was thought that those with HIV might not develop Alzheimer’s because HIV-related inflammation in the brain might prevent these amyloid clumps from forming.

Reports suggest that HIV–associated neurocognitive disorder (HAND) can be found in 30 percent to 50 percent of patients with long-term HIV infection, and its symptoms are similar to those of Alzheimer’s.

The Campbell Foundation has long recognized the association between HIV and HAND and has funded related research projects dating back to 2004.

Here’s a brief review:

In August, 2004, The Campbell Foundation provided a $78,650 grant to Dr. Steven Wesselingh at the Burnet Institute in Melbourne Australia to study the role of HIV infection of Astrocytes in the Development of HIV-Associated Dementia. Today, the infectious disease physician and researcher in neurovirology and vaccine development, is executive director of the South Australian Health & Medical Research Institute.

HIV infects the brain causing dementia in 10 percent to 20 percent of patients. Strategies aimed at eradicating HIV infection failed to take into account central nervous system (CNS) infection. Understanding the way in which HIV enters, infects and replicates in the brain is pivotal in the development of drugs to prevent brain infection and dementia. Dr. Wesselingh’s Campbell Foundation-funded studies have shown that HIV infection of the brain involves mechanisms distinct to those observed for blood and other organs.

In a follow up with Dr. Wesselingh, he noted that our initial grant allowed him to garner enough preliminary data to obtain another $400,000-plus in additional financing from two other funding organizations.

In May 2011, the foundation provided a $32,919 grant to Drs. Micheline McCarthy and Rebecca Geffin at the University of Miami School of Medicine to study how Host Apolipoprotein E Affects the Development of HIV-Associated Neurological Disease.

This research team wanted to explore the observation that HIV-1 associated memory loss and cognitive problems were becoming more prevalent in the HIV+ population. Their research asked how HIV infection could cause subtle, but perceptible impairment of the brain, and how HIV's effects on the brain may be influenced by host-determined factors, such as apolipoprotein E (a protein involved in Alzheimer's as well as cardiovascular disease). Their research was published in the Journal of Neuroimmune Pharmacology, as well as an oral presentation at the 12th International Symposium on Neurovirology.

And, as recently as July 2013, we awarded an $88,000 grant to Dr. Velpandi Ayyavoo, a researcher at the University of Pittsburg to study MicroRNAs as biomarkers for HAND.

MicroRNAs are one of the early biological responses for many diseases, including HIV. Studies had shown that these molecules are present in body fluids (such as plasma), and can be readily measured using a variety of diagnostic tools. Dr. Ayyavoo and her team wanted to develop a sensitive MicroRNA-based biomarker tool to detect neurocognitive impairment in HIV-infected subjects. The goal of their study was to facilitate early detection of these biomarkers to help in the design of better treatment options for HIV-associated neurocognitive disorder (HAND).

The most recent discovery by Georgetown University researchers, which was published in Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring, disputes what researchers initially thought they knew about dementia in HIV-positive patients. HIV-infected individuals over the age of 55 make up the fastest growing age group in the HIV-positive population.

The latest findings underscore the importance of further study into HIV-related neurological conditions, and raises the possibility that Alzheimer’s exists in others with HIV, but has been misdiagnosed.

The Campbell Foundation has long recognized the importance of not only funding research that will lead to a cure for HIV/AIDS, but also for research on diseases and comorbidities associated with the disease.

As has been our practice since 1995, we will continue to fund nascent research in hopes that those we fund will be able to go on and find a cure for the disease and its associated comorbidities.

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