The CNS HIV Anti-Retroviral Therapy Effects Research (CHARTER) study was first funded in September 2002 to investigate how combination antiretroviral therapy (ART) affected brain health disorders (e.g., AIDS dementia) and peripheral nervous system complications (e.g., peripheral neuropathy). To have broad representation of people with HIV (PWH), participants enrolled at six sites across the U.S.: Icahn School of Medicine at Mt. Sinai, Johns Hopkins University, University of California, San Diego, University of Texas Medical Branch, Galveston, University of Washington, and Washington University in St. Louis. Participants were evaluated with comprehensive neuromedical, neurocognitive, and laboratory assessments, with a subset undergoing host and viral genotyping and brain imaging.
After 12 years, the project transitioned to a focus on premature aging in PWH. This next phase began in 2015 and recalled 402 CHARTER participants for re-assessment. The major aim was to determine if PWH who were older than 60 years would have greater neurocognitive decline over 12 years than younger PWH, while controlling for effects of “typical aging” based on a normative population of people without HIV. Adding to the timeliness and relevance of this study, the project also assessed viral, immune, cardiometabolic, pharmacologic, and biological indicators of aging.
The current phase is named CHARTER Plus and began in 2021. CHARTER Plus is a resource project that focuses on performing updated, comprehensive assessments of 500 participants and making the data and biospecimens available for cutting-edge research of brain health disorders in PWH. The goal is to enable research on the neurologic, cognitive, psychiatric, and drug use disorders that PWH across their lifespan. For the first time since CHARTER’s inception, the cohort is assessing new groups of participants. In addition to 200 PWH who have been followed in CHARTER for nearly two decades, CHARTER Plus adds: 100 new participants diagnosed with HIV infection within the past 10 years on suppressive ART (subgroup A), 100 new participants without HIV who have comparable demographic and risk behavior characteristics (subgroup B), and 100 new people without HIV who are older than 50 years and have a family history of dementia (subgroup C). Each of these new groups enable research that will address key gaps in the field, including understanding the legacy effects of advanced HIV disease (subgroup A), the influence of co-existing conditions like drug use (subgroup B), and the differences between older PWH and people without HIV in brain health (subgroup C). To strengthen CHARTER’s rich resource, the project has expanded its comprehensive assessments and is assessing participants twice over five years to enable longitudinal analyses. All CHARTER Plus data and biospecimens are available to the scientific community through the National NeuroHIV Tissue Consortium (NNTC).
Regarding NNTC, CHARTER resource management was integrated into the NNTC in 2015. Database maintenance and curation, processing of resource requests, and other coordinating responsibilities are coordinated by NNTC at the Data Coordinating Center, which is located at the University of Nebraska and The Emmes Company. Biospecimens continue to be housed at UCSD for distribution.
Applications to request CHARTER specimens and/or data will be routed through this website. Visit the NNTC Query Tool Training Materials page for more information. To submit an application, please use the NNTC Query Tool. Contact Donald Franklin (dofranklin@health.ucsd.edu). The NNTC and CHARTER studies share some similarities in assessments and data, but differences exist, such as the focus on PWH who are at high risk for death and the inclusion of brain imaging in CHARTER. The projects are complementary and share the goals of advancing the neuroHIV field.