About the HNRC

Our Mission

The Mission of the HNRC is to: 1) stimulate and support interdisciplinary collaborative research on neuroHIV at the local, national, and international levels that address emergent scientific themes and NIH Office of AIDS Research (OAR) priorities; 2) serve as a resource for scientific leadership, consultation, and training in neuroHIV research with the goal of stimulating new scientific discoveries that advance HIV research and have a long-lasting impact on the field; 3) facilitate research by providing a rich research infrastructure with access to state-of-the-art expertise and training in novel technologies, assays, and methods, as well as support from highly qualified data management and statistics teams; and 4) provide access to data and biospecimens from existing large, longitudinal, well-characterized cohorts of persons with or without HIV; and 5) provide recruitment and maintenance of cohorts to meet the needs of new and existing investigators.

About the HNRC

The overarching aim of the HIV Neurobehavioral Research Center (HNRC) is to provide scientific leadership, research infrastructure, participant resources (cross-sectional and longitudinal data and biospecimens available for associated studies), and technical support for a broad range of research that addresses NIH Office on AIDS Research (OAR) priorities – specifically, comorbidities, coinfections, and complications in persons with HIV (PWH). The HNRC focuses on the mechanisms underlying the development and persistence of central nervous system (CNS) complications in PWH, and factors that may adversely affect PWH. The Center provides resources that facilitate basic, clinical, and translational research that addresses neuroHIV mechanisms and consequences. Areas of ongoing emphasis include HIV eradication from the CNS and alterations in the gut microbiome as contributors to poor CNS outcomes. A newer area of increased emphasis is depression and how it interacts with cognition to affect outcomes of public health importance, including healthcare engagement, disease progression, everyday functioning, and quality of life.

The HNRC is organized as a set of four Scientific Cores and a Developmental Core, with the work of these entities being harmonized by an Administrative Core. The Scientific Cores were chosen to provide the techniques and resources necessary for the next generation of neuroHIV research. They include Cores in NeuroBehavioral and Psychiatry, NeuroMedical, Microbiome, and NeuroVirology and Biology.

The Administrative Core, through its Coordinating Unit, implements the strategic plan and policies of the Executive Team by coordinating activities of all Cores and Units. The HNRC Executive Team is charged with guiding the Center’s scientific direction and allocation of resources. In addition to the HNRC Directors (D. Moore and R. Ellis), the Executive Team is comprised of the Center Co-Directors (I. Grant and S. Letendre), the Center Manager (J. Iudicello) and the Associate Center Manager (D. Franklin).

Other center-wide resources within the Administrative Core include the Data Management and Information Systems Unit, Statistics Unit, and Participant Accrual and Retention Unit. The Core also utilizes several internal committees: a) Research Review Committee (meets weekly to review research proposals, manuscripts and grants, and for scientific updates); b) Human Subjects Committee (participant welfare, assurance of informed consent and confidentiality); and c) HNRC Operations Workgroup (which meets weekly and consist of the Center Manager and the Core Managers and addresses troubleshooting and project implementation across studies.

BACKGROUND AND SIGNIFICANCE

Despite dramatic reductions in HIV-related mortality and morbidity in the era of modern anti-retroviral therapy (ART), the negative consequences of HIV and related comorbidities on central nervous system (CNS) functioning remains prevalent, with 30-50% of HIV+ patients exhibiting HIV associated neurocognitive disorders (HAND), even in the presence of undetectable viral levels. Although often characterized as mild, such impairments can affect every-day functioning (e.g., the ability to adhere to medication regimens), and their presence may yet yield insights regarding on-going, low-level viral presence in the CNS, and other neuropathological processes. The prevalence of such complications is expected to increase as the HIV-infected population ages. Depression also is highly prevalent among PWH and often can be concurrent with NCI, suggesting that they may share some systemic and neurobiological mechanisms. Like NCI, depression is not a unitary phenomenon: in different patterns and degrees, depressed mood is linked to other mental health factors such as anhedonia, apathy, anxiety, somatic features, and loneliness. The relationships between depression and cognition are complex and remain poorly understood. Depression has been linked to subjective and objective NCI, and with cognitive decline over time. Still, many questions remain regarding the interactions between depression and NCI in PWH, including whether NCI improves following treatment of depression and, if so, which mechanisms underlie such improvements. Thus, the HNRC aims to support mechanistic and clinical studies evaluating the reciprocal effects of cognitive and depressive disorders, and related biological factors (e.g., inflammation, gut dysbiosis) over time.

OVERALL AIM

The overarching aim of the HIV Neurobehavioral Research Center (HNRC) is to provide scientific leadership, research infrastructure, participant resources (cross-sectional and longitudinal data and biospecimens available for associated studies), and technical support for a broad range of research that addresses NIH Office on AIDS Research (OAR) priorities – specifically, comorbidities, coinfections, and complications in persons with HIV (PWH). The HNRC focuses on the mechanisms underlying the development and persistence of central nervous system (CNS) complications in PWH, and factors that may adversely affect PWH. The Center provides resources that facilitate basic, clinical, and translational research that addresses neuroHIV mechanisms and consequences. Areas of ongoing emphasis include HIV eradication from the CNS and alterations in the gut microbiome as contributors to poor CNS outcomes. An area of increased emphasis in this renewal will be depression and how it interacts with cognition to affect outcomes of public health importance, including healthcare engagement, disease progression, everyday functioning, and quality of life.

To support such investigations HNRC: 1) Maintains a Participant Registry of HIV+ and HIV- participants with longitudinal data; 2) Enhances, maintains, and provides data and biospecimen resources to support new neuroHIV research; 3) Refines novel remote assessment capabilities and onsite assessment methods; 3) Provides expertise, intellectual leadership, and mentoring to support new research and new investigators in neuroHIV; and 4) Provides funding to support pilot studies that will lead to impactful findings and new research project applications and will advance the careers of new investigators.

Lastly, the HNRC will continue its highly successful approach to enhancing infrastructure and capacity-building, both domestically and internationally, as a means of multiplying the value of investments in the HNRC. In particular, we shall continue to serve as an incubator of trainees and young investigators that can populate the next generation of HIV neuroAIDS scientists.