Thanks to antiretroviral drugs, many fewer HIV-infected people experience frank dementia anymore. Nevertheless, more than half of HIV-positive patients treated with antiretrovirals suffer from milder, lifelong HIV-associated neurocognitive disorders, or HAND. Joan W. Berman, Ph.D., professor of pathology and of microbiology & immunology, recently received two NIH grants totaling $7.4 million to study the sequence of events that lead to HAND, examine how certain drugs of abuse increase the risk for HAND, and develop strategies for preventing the disorder. Dr. Berman also holds the Irving D. Karpas M.D. Chair for Excellence in Medical Research.

HAND occurs after HIV-infected white blood cells manage to cross the blood brain barrier, resulting in inflammation, damage to neurons, and persistent reservoirs of virus in the brain. Dr. Berman and Susan Morgello, M.D., of Mount Sinai Icahn School of Medicine, were awarded a five-year, $3.6 million grant from the National Institute of Mental Health to study a particular population of white cells known to be responsible for HAND. The researchers will follow the migration of these cells in HIV-positive patients and study the proteins that regulate the transit of white cells across the blood brain barrier. The research may lead to therapies that block HIV-infected white cells from entering the brain. (1R01MH112391-01A1)

Drugs of abuse and even certain antiretroviral therapies appear to increase the risk for developing HAND. Dr. Berman and Harris Goldstein, M.D., have been awarded a five-year, $3.8 million grant from the National Institute on Drug Abuse (NIDA) to study the interactions among methamphetamines and other drugs of abuse, antiretroviral therapeutics and HIV infection. The researchers hypothesize that methamphetamines and some antiretrovirals weaken the integrity of the blood brain barrier, making it easier for HIV-infected white blood cells to enter the brain. Their research will also use a mouse model of HIV. Dr. Goldstein is professor of pediatrics and of microbiology & immunology and director of the Einstein-Rockefeller-CUNY Center for AIDS Research. He also holds the Charles Michael Chair in Autoimmune Diseases at Einstein. (1R01DA044584-01)