Newswise — November 16, 2021—(BRONX, NY)— The Bronx is home to more than 27,000 people living with HIV, the majority of whom are Black or Hispanic men. People living with HIV have an increased risk for depression and substance use, which in turn can make adhering to daily antiviral treatments difficult, negatively impacting both quality of life and overall health.
Now, the National Institutes of Health (NIH) has awarded researchers at Albert Einstein College of Medicine and Montefiore Health System two five-year grants totaling $7.6 million to study the structural and chemical changes in the brains of people living with HIV, depression, and cannabis use disorder.
“Given the health disparities associated with both a mental health diagnosis and HIV-positive status, we’re hopeful our findings will serve as an important step in advancing health equity in the Bronx and around the country,” said Vilma Gabbay, M.D., M.S., co-director of the Psychiatry Research Institute at Montefiore Einstein and co-principal investigator on both grants.
Cannabis Use and Depression in People with HIV
The first research project, funded by a five-year, $4 million grant, will enroll 280 people ages 18-34 who are living with HIV. Some of the participants will have depression and regularly use cannabis. Investigators will use neuroimaging, including functional MRI, to examine brain circuitry related to reward and pain to better understand their links to depression and substance use disorder in this population. Principal investigators on the grant are Dr. Gabbay, Anjali Sharma, M.D., M.S., associate professor of medicine at Einstein and an internist and infectious diseases specialist at Montefiore; and Joanna Starrels, M.D., M.S., associate professor of medicine at Einstein and an internist and addiction medicine specialist at Montefiore.
“Our collaborative project involves experts in depression, HIV, addiction medicine, and neuroimaging, who will investigate the role of neural mechanisms to learn about the connection between cannabis use and depression in people living with HIV,” said Dr. Gabbay, who is also associate professor of psychiatry and behavioral sciences and in the Dominick P. Purpura Department of Neuroscience at Einstein. “We hope to identify specific biomarkers of depression and develop better treatments.”
Understanding Depression in People Living with HIV
The second project, funded by a five-year, $3.6 million grant, will examine how the immune system, brain circuits, and neurochemicals interact in people living with HIV. Investigators, led by Dr. Gabbay and Dr. Sharma, who co-chair the HIV and Mental Health Scientific Working Group for the Einstein-Rockefeller-CUNY Center for AIDS Research, hope to untangle this complex system to understand why these individuals are more vulnerable to depression.
The Einstein-Montefiore researchers believe that when the central nervous system (CNS) becomes inflamed by HIV, it results in two adverse effects: chemicals called free radicals injure nerves of the CNS and levels of gamma-aminobutyric acid (GABA)—a neurotransmitter known to have a calming effect—are reduced. These neurochemical changes are believed to cause depression.
“If we can confirm that this chain of events leads to depression,” said Dr. Gabbay, “we may be able to devise treatment strategies that can ward off depression in people infected by HIV—perhaps by inhibiting the inflammatory proteins that accompany HIV infection.”
Researchers will enroll 300 people living with and without HIV. At the start of the study, participants will be tested for levels of depression or anxiety, past psychiatric trauma, HIV treatment, and levels of CD4+ T cells (a type of T cell affected by HIV infection). The tests will be repeated after six and 12 months.
The first grant, titled “The Neural Underpinnings of Depression and Cannabis Use in Young PLWH,” was awarded by the National Institute on Drug Abuse, part of the National Institutes of Health (1R01DA054885-01). The second grant, initially titled “The Neuroimmunology of Depression in Women Living With HIV,” was awarded by the National Institute of Mental Health, part of the National Institutes of Health (1R01MH128878-01).
About Montefiore Health System
Montefiore Health System is one of New York’s premier academic health systems and is a recognized leader in providing exceptional quality and personalized, accountable care to approximately three million people in communities across the Bronx, Westchester and the Hudson Valley. It is comprised of 10 hospitals, including the Children's Hospital at Montefiore, Burke Rehabilitation Hospitaland more than 200 outpatient ambulatory care sites. The advanced clinical and translational research at its medical school, Albert Einstein College of Medicine, directly informs patient care and improves outcomes. From the Montefiore-Einstein Centers of Excellence in cancer, cardiology and vascular care, pediatrics, and transplantation, to its preeminent school-based health program, Montefiore is a fully integrated healthcare delivery system providing coordinated, comprehensive care to patients and their families. For more information, please visit www.montefiore.org. Follow us on Twitter and Instagram and LinkedIn, or view us on Facebook and YouTube.
About Albert Einstein College of Medicine
Albert Einstein College of Medicine is one of the nation’s premier centers for research, medical education and clinical investigation. During the 2020-21 academic year, Einstein is home to 721 M.D. students, 178 Ph.D. students, 109 students in the combined M.D./Ph.D. program, and 265 postdoctoral research fellows. The College of Medicine has more than 1,900 full-time faculty members located on the main campus and at its clinical affiliates. In 2020, Einstein received more than $197 million in awards from the National Institutes of Health (NIH). This includes the funding of major research centers at Einstein in aging, intellectual development disorders, diabetes, cancer, clinical and translational research, liver disease, and AIDS. Other areas where the College of Medicine is concentrating its efforts include developmental brain research, neuroscience, cardiac disease, and initiatives to reduce and eliminate ethnic and racial health disparities. Its partnership with Montefiore, the University Hospital and academic medical center for Einstein, advances clinical and translational research to accelerate the pace at which new discoveries become the treatments and therapies that benefit patients. Einstein runs one of the largest residency and fellowship training programs in the medical and dental professions in the United States through Montefiore and an affiliation network involving hospitals and medical centers in the Bronx, Brooklyn and on Long Island. For more information, please visit www.montefiore.org. Follow us on Twitter and Instagram and LinkedIn, or view us on Facebook and YouTube.