Mood Disorders in People Living with HIV: Mechanisms and Pathways
Presenter:
Vasudev Rao, MBBS, M.S.
Division of AIDS Research
Goal:
The purpose of this initiative is to support studies to better understand the interplay of biological, behavioral, emotional and psychosocial mechanisms and pathways that underlie mood disorders in people living with HIV (PLHIV)
Rationale:
In the U.S. and globally, mood disorders are a significant co-morbidity among PLHIV on stable antiretroviral therapy (ART). Mood disorders are associated with increased transmission of risk behaviors as well as impact HIV care and treatment outcomes. Biological (genetic, neuroendocrine, immune, microbiome), psychosocial (traits, stress, internalized stigma, trauma, coping, social support), and structural (violence, stigma, poverty) factors interact to influence the development of mood disorders among PLHIV. Despite mood disorders being a significant co-morbidity, the majority of the research in the NeuroHIV realm has focused on cognitive dysfunction due to high rates of AIDS dementia outcomes in the pre-ART era. To date, few studies have longitudinally and concurrently examined somatic (e.g., HIV- and ART-related inflammatory and/or neuroimmune changes) and non-somatic (e.g., violence, stigma, stress) etiologies of mood disorders among PLHIV. A better understanding of the mechanisms underlying mood disorders in PLHIV can lead development of novel interventions in these populations.
To address the above research gaps, this initiative encourages applications such as:
- Basic and clinical studies of the biological, behavioral and psychosocial mechanisms of mood disorders in PLHIV on ART;
- Studies of functional changes in brain neurochemistry and neuroendocrine milieu that lead to mood disorders in the context of HIV and ART;
- Studies that model the impact of HIV and associated inflammation in the CNS and periphery (including the gut-brain axis) on brain circuits and networks regulating mood;
- Studies to examine the independent and interactive effects of non-somatic and somatic causes of mood disorders on brain neurochemistry and response to evidence based treatment options in PLHIV;
- Studies to identify novel biological signatures of immune activation and inflammation associated with mood disorders in PLHIV that can serve as treatment response predictors;
- Studies to understand the mechanistic role of genetic and epigenetic factors influencing outcomes related to mood disorders in PLHIV;
- Studies to investigate the impact of mental health interventions on the neuroimmune/ neuroendocrine milieu in PLHIV, that include viral load and CD4-related outcomes;
- Studies to identify modifiable pre-clinical targets, by deciphering the mechanisms leading to mood disorders unique to PLHIV.