Every week through the month of December – AIDS Awareness Month – a Drexel University College of Medicine research study will be highlighted to showcase the important contributions our faculty are making to AIDS research. In the United States, more than 1.5 million people are living with HIV, according to a 2010 report issued by the Joint United Nations Programme on HIV/AIDS. That is a sobering number of Americans who will have to endure the long-term effects of life with AIDS.

While antiretroviral treatment has extended the life expectancy of patients with HIV, it has not diminished the long-term adverse effects of the disease such as cognitive decline. Antiretrovirals are designed primarily to prevent replication of HIV in activated T-cells and other secondary target cells.

However, virus replication can also lead to bystander cell damage that has a particularly negative impact within the central nervous system, ultimately leading to neurocognitive impairment. Commonly known as neuroAIDS, this condition afflicts from 25 to 50 percent of HIV patients, according to a study reported in Neurology Today (October 7, 2010). Investigators also reported that HIV patients with neurological conditions had twice the risk of dying from AIDS.

Brian Wigdahl, PhD, chair of the Department of Microbiology & Immunology and director of the Institute for Molecular Medicine & Infectious Disease, is principal investigator of a $3.5 million five-year grant from the National Institute on Drug Abuse to identify very specific viral genetic markers to predict HIV patients who would be at higher risk for developing neurocognitive impairment. The research goal is to develop a viral molecular diagnostic assay to enable clinicians to identify the most appropriate patients to receive neuroprotective therapy before the onset of impairment.

Wigdahl and co-investigators Jeffrey Jacobson, MD, Michael Nonnemacher, PhD, and Julio Martin-Garcia, PhD, are also studying the impact of substance abuse on the development of neuroAIDS in a cohort of approximately 500 HIV-infected patients who have been identified as preferential users of either cocaine or cannabinoids. One of the largest longitudinal studies of its kind in the United States, this project will help researchers understand how substance abuse alters the genetic structure of the virus during the course of HIV/AIDS, as well as the course of the disease itself. It will also allow researchers to understand what impact these genetic changes will have on the response of HIV to currently available antiretroviral therapeutic strategies. These studies may be critical to the development of the next generation of anti-HIV drugs.