Acquired Immunodeficiency Syndrome; Antiviral Agents; Cerebrospinal Fluid; Dementia; HIV; Nervous System; Neurology; Magnetic Resonance Spectroscopy; Biomarkers, Pharmacological
Public Health Interests
Antivirals; Biomarkers; Dementia; Disease transmission; HIV/AIDS; Immune functions; Infectious Disease; Viruses
Our group’s clinical and translational research focuses on characterization of the central nervous system in HIV-infected patients in an effort to understand and treat the processes underlying damage to the nervous system by HIV, as well as establishment and reduction of potential central nervous system reservoirs for infection.
Our current program employs a multidisciplinary approach to patient-oriented research in neuro-HIV, through active collaborations with researchers in immunology, radiology, neuropsychology, virology, and molecular biomarkers. We apply these methods to novel studies of patients that may inform about neuroprotection and neuropathogenesis in HIV, including individuals with acute or early HIV infection, elite controllers who maintain undetectable viral loads in the absence of antiretroviral therapy, and patients at different stages of treatment with antiretroviral therapy. We are also performing clinical studies aimed to examine and/or reduce early establishment of central nervous system reservoirs for HIV infection.
Our studies focus on subjects recruited in urban centers in the US and other international sites including Bangkok, Thailand. Broader involvement with the design and implementation of multicenter studies relevant to neuro-HIV is facilitated by Dr. Spudich’s leadership position within the international AIDS Clinical Trials Group (ACTG), facilitated by an affiliation with the Cornell AIDS Clinical Trials Unit.
Specialized Terms: HIV; AIDS; Central nervous system inflammation; Viral compartmentalization; Acute infection; HIV reservoirs; Magnetic resonance spectrocsopy; Diffusion tensor imaging; Neural markers; Cerebrospinal fluid biomarkers
- Hellmuth J, Fletcher JL, Valcour V, Kroon E, Ananworanich J, Intasan J, Lerdlum S, Narvid J, Pothisri M, Allen I, Krebs SJ, Slike B, Prueksakaew P, Jagodzinski LL, Puttamaswin S, Phanuphak N, Spudich S; SEARCH 010/RV254 Study Group. Neurologic signs and symptoms frequently manifest in acute HIV infection. Neurology. 2016 Jul 12;87(2):148-54
- Wright PW, Pyakurel A, Vaida FF, Price RW, Lee E, Peterson J, Fuchs D, Zetterberg H, Robertson KR, Walter R, Meyerhoff DJ, Spudich SS, Ances BM. Putamen volume and its clinical and neurological correlates in primary HIV infection. AIDS. 2016 Jul 17;30(11):1789-94.
- Gega A, Kozal MJ, Chiarella J, Lee E, Peterson J, Hecht FM, Liegler T, St John EP, Simen BB, Price RW, Spudich SS. Deep sequencing of HIV-1 variants from paired plasma and cerebrospinal fluid during primary HIV infection. J Virus Erad. 2015;1(4):264-268.
- Young AC, Yiannoutsos CT, Hegde M, Lee E, Peterson J, Walter R, Price RW, Meyerhoff DJ, Spudich S. Cerebral metabolite changes prior to and after antiretroviral therapy in primary HIV infection. Neurology. 2014 Sep 26.
- Cerebrospinal fluid and neuroimaging biomarker abnormalities suggest early neurological injury in a subset of individuals during primary HIV infection. Peluso MJ, Meyerhoff DJ, Price RW, Peterson J, Lee E, Young AC, Walter R, Fuchs D, Brew BJ, Cinque P, Robertson K, Hagberg L, Zetterberg H, Gisslén M, Spudich S. J Infect Dis. 2013 Jun 1;207(11):1703-12.
- Cerebrospinal fluid HIV escape associated with progressive neurologic dysfunction in patients on antiretroviral therapy with well controlled plasma viral load. Peluso MJ, Ferretti F, Peterson J, Lee E, Fuchs D, Boschini A, Gisslén M, Angoff N, Price RW, Cinque P, Spudich S. AIDS. 2012 Sep 10;26(14):1765-74.
- Spudich S, Gisslen M, Hagberg L, Lee E, Liegler T, Brew B, Fuchs D, Tambussi G, Cinque P, Hecht FM, and Price RW. Central Nervous System Immune Activation Characterizes Primary HIV-1 Infection Even in Subjects with Minimal Cerebrospinal Fluid Viral Burden. Journal of Infectious Diseases, 2011; 204(5):753-60.
- Kore I, Ananworanich J, Valcour V, Fletcher JL, Chalermchai T, Paul R, Reynolds J, Tipsuk S, Ubolyam S, Rattanamanee S, Jagodzinski L, Kim J, Spudich S; RV254/SEARCH 010 Study Group. Neuropsychological Impairment in Acute HIV and the Effect of Immediate Antiretroviral Therapy.J Acquir Immune Defic Syndr. 2015 Dec 1;70(4):393-9.
- Sturdevant CB, Joseph SB, Schnell G, Price RW, Swanstrom R, Spudich S. Compartmentalized replication of R5 T cell-tropic HIV-1 in the central nervous system early in the course of infection. PLoS Pathog. 2015 Mar 26;11(3):e1004720.