Bone, Brain, Heart study protocol: A resilient nested, tripartite prospective cohort study of the role of estrogen depletion on HIV pathology

• Authors: Christina Mehta, Emory University; Kimberly S Hagen, Emory University; Anna A Rubtsova, Emory University; Cecile Lahiri, Emory University; Vasiliki Michopoulos, Emory University; Caitlin Moran, Emory University; Lisa Haddad, Emory University; Kehmia Titanji, Emory University; Lauren Collins, Emory University; Arshed Quyyumi, Emory University; Gretchen Neigh, Emory University; Leslee Shaw, Emory University; M. Neale Weitzmann, Emory University; Lance Waller, Emory University; Ighovwerha Ofotokun, Emory University
• Journal Title: PLOS ONE
• Volume: Volume 17, Number 8
• Publisher: PUBLIC LIBRARY SCIENCE | 2022-01-01, Pages e0272608-e0272608
• Type of Work: Article | Final Publisher PDF
• Publisher DOI: http://doi.org/10.1371/journal.pone.0272608
• Subjects: Health Sciences, Mental Health; Health Sciences, Public Health
• Keywords: Science & Technology; Multidisciplinary Sciences; Science & Technology - Other Topics; HUMAN-IMMUNODEFICIENCY-VIRUS; WOMENS INTERAGENCY HIV; INFECTED PATIENTS; MINERAL DENSITY; ANTIRETROVIRAL THERAPY; MICROBIAL TRANSLOCATION; MYOCARDIAL-INFARCTION; CARDIOVASCULAR RISK; INFLAMMATION; POPULATION

Abstract

Purpose We describe the rationale for and design of an innovative, nested, tripartite prospective observational cohort study examining whether relative estrogen insufficiency-induced inflammation amplifies HIV-induced inflammation to cause end organ damage and worsen age-related co-morbidities affecting the neuro-hypothalamic-pituitary-adrenal axis (Brain), skeletal (Bone), and cardiovascular (Heart/vessels) organ systems (BBH Study). Methods The BBH parent study is the Multicenter AIDS Cohort/Women's Interagency HIV Study Combined Cohort Study (MWCCS) with participants drawn from the Atlanta MWCCS site. BBH will enroll a single cohort of n = 120 women living with HIV and n = 60 HIV-negative women, equally distributed by menopausal status. The innovative multipart nested study design of BBH, which draws on data collected by the parent study, efficiently leverages resources for maximum research impact and requires extensive oversight and management in addition to careful implementation. The presence of strong infrastructure minimized BBH study disruptions due to changes in the parent study and the COVID-19 pandemic. Conclusion BBH is poised to provide insight into sex and HIV associations with the neuro-hypothalamicpituitary-adrenal axis, skeletal, and cardiovascular systems despite several major, unexpected challenges.