• Kumar, Mahendra (PI)

Project: Research project

Project Details


There is considerable variability in the clinical progression of HIV
infection. A number of variables, including a possible defect in the
physiological systems mediating coping responses to stressors, are among
the hypotheses proposed to explain this variability. Our recent studies
showing a blunted norepinephrine response to a cold pressor challenge in
HIV+ subjects supports such hypotheses. A major objective of the present
proposal is to investigate within an experimentally controlled alpha-and
beta-adrenergic challenge paradigm, relationships between autonomic, and
HPA axis responses (NE, E, ACTH, Cortisol) that might be related to the
stage of HIV-I disease. Furthermore, since relationships among
neurohormone, and immune functions have been sufficiently established to
permit the advancement of hypotheses relating the role of psychological
and behavioral variables in the progression of an immune disease, we also
propose to investigate 24-hour urinary NE, E and their metabolites, and
cortisol, biological markers of field stressors, as a function of
progression of HIV-1 infection.

This proposal will examine the responses to evaluative speech, cold
pressor and mirror tracing challenges in HIV infection using a cross-
sectional design. A group of 90 homosexual subjects (HIV seropositive,
CDC stage 1A, 1B, CD4 count greater than 500/cumm, N= 30; HIV+ subjects,
CDC stage 2A, 2B, CD4 count 200-500, but no signs of opportunistic
infections, N= 30; and HIV-(N= 30) will be enrolled for this study. The
responses in the two HIV+ groups and HIV- subjects, will be compared.
Also, reactivity results from HIV+ subjects in different stages of the
disease will be investigated as a function of CD4 cell counts and other
immune markers.

The data will be used in determining the role of successful coping with
the environmental and acute stressors in the progression of HIV
infection. The data may also help in planning behavioral and/or
pharmacological interventions designed to normalize coping responses to
stressors which may help to delay the progression of HIV-1 infection.
Effective start/end date9/30/958/31/98


  • National Institute of Mental Health
  • National Institute of Mental Health


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