Grant: Operating Grant: Innovative Biomedical and Clinical HIV/AIDS Research

People with HIV/AIDS often experience impaired memory, slowed physical or mental functions, and behaviours such as apathy or agitation. This group of signs and symptoms is called 'HIV-associated neurocognitive disorder' or HAND. HAND can affect people with HIV/AIDS even when they receive anti-HIV treatments, and HAND has no specific treatment. HAND can reduce people's ability to take medications, employability, quality of life, and survival, with increased health care costs. Our research group established the first ongoing study of HAND in Canadians with HIV/AIDS. We found that HAND affects about 25% of people with HIV/AIDS. We have identified Type 2 diabetes and age-related disorders as major risk factors for developing HAND. Using our experimental models, we have also discovered a novel approach for treating HAND using intranasal insulin (administered through the nose). We now aim to translate our research findings into a treatment for people with HAND. Intranasal insulin treatment has already been tested in people with Alzheimer's disease and showed beneficial effects on memory, mood and quality of life. We propose to perform a clinical study of intranasal insulin in people with HAND. We will measure how intranasal insulin changes quality of life, mood, brain function, and levels of biological markers for HAND in cerebrospinal fluid and blood. We plan to enroll 30 people with HAND over 18 months and treat them with intranasal insulin or placebo for 4 months. If this proof of concept study shows improved brain function (especially memory), quality of life or mood, we will proceed to a larger clinical trial and eventually to clinical use of intranasal insulin. The expected benefits to people with HAND include improved mental functions, better mood and quality of life as well as reduced healthcare expenses.