NOSI: Notice of Special Interest: Resilience and Vulnerability following Acute Heart, Lung, Blood, and Sleep Insults in People with HIV (R01, Clinical Trial Not Allowed)
Notice Number:

Key Dates

Release Date:

September 30, 2021

First Available Due Date:
January 07, 2022
Expiration Date:
January 08, 2024

Related Announcements

PA-20-185 - NIH Research Project Grant (Parent R01 Clinical Trial Not Allowed)

Issued by

National Heart, Lung, and Blood Institute (NHLBI)


Background and Purpose:

Worldwide, over 37 million people are living with HIV. Despite the success of combination antiretroviral therapy (ART) in achieving durable virologic suppression, people with HIV (PWH) are at increased risk for multiple comorbidities. Specifically, studies have shown that PWH are more likely to experience chronic heart, lung, blood, and sleep-related (HLBS) comorbidities, such as cardiomyopathy, chronic obstructive pulmonary disease (COPD), and anemia. Additionally, studies have shown that PWH may experience acute HLBS conditions, including myocardial infarction and acute infectious pneumonia, differently than HIV-uninfected individuals. An area that remains relatively understudied is how PWH experience long-term consequences of an acute HLBS illness/physiologic insult, and whether PWH suffer greater consequences as a result of these acute insults.

The responses to an acute HLBS insult and the mechanisms and determinants of complete recovery vs. persistent residual dysfunction vs. transition to progressive dysfunction/injury define a particular segment of the broader area of inquiry commonly referred to as resilience. This particular subdomain of resilience has been recently thrust into the spotlight by the COVID-19 pandemic. It is increasingly recognized that the acute HLBS insults associated with COVID-19 – myocardial injury, acute respiratory distress syndrome (ARDS), and multisystem microvascular and macrovascular thromboses – are likely associated with long-term HLBS dysfunction in some patients. How these transitions of disease occur and how they may differ in PWH is not at all well understood. More broadly, how PWH may transition between acute HLBS disease and more chronic manifestations differently than people who are HIV-negative is a notable gap in knowledge. This NOSI is intended to begin to address this knowledge gap across the spectrum of HLBS disease research.

Research Objectives:

This NOSI encourages the submission of research project applications focused on understanding the long-term manifestations of acute HLBS illnesses with an emphasis on host response, viral pathways, and mechanisms that contribute to long-term manifestations in the context of HIV. Proposals considered responsive to the NOSI may address questions across the spectrum of basic science to population science.

Topics and potential studies of particular interest include, but are not limited to:

  • How people with HIV (PWH) experience chronic consequences of acute physiologic heart, lung, blood, and sleep (HLBS) insults
  • Whether PWH are more likely to manifest long-term consequences or have more severe long-term effects to acute HLBS insults when compared to HIV-uninfected individuals
  • Whether PWH experience a different transition to chronic disease than HIV-uninfected individuals
  • Factors responsible for resilience or impaired resilience following an acute insult in PWH, including determining whether there are factors related to the virus itself or other underlying host factors
  • Whether tissue (e.g., lungs, heart, hematopoietic tissues) reparative mechanisms are affected by the presence of HIV infection , and whether antiretroviral therapy (ART) agents shape tissue repair
  • Determining if the tissue reparative/regeneration functions of the immune system are impacted by the presence of HIV following an acute HLBS insult, and whether ART agents shape these processes
  • Whether host responses to HIV and to HLBS insults mechanistically act alone and/or in conjunction to shape resilience
  • The effect of aging, race/ethnicity, or sex and gender differences on resilience to acute HLBS insults in PWH when compared to those who are HIV negative
  • Investigating if social determinants of health (SDOH) affect resilience to acute HLBS insults in PWH, and whether SDOH affect PWH differently when compared to those who are HIV negative

Application and Submission Information

Submit applications for this initiative using the following Funding Opportunity Announcements (FOA) or any reissue of this announcement.

  • PA-20-185- NIH Research Project Grant (Parent R01 Clinical Trial Not Allowed)

All instructions in the SF424 (R&R) Application Guide and the funding opportunity announcement used for submission must be followed, with the following additions:

  • For funding consideration, applicants must include “NOT-HL-22-002” (without quotation marks) in the Agency Routing Identifier field (box 4B) of the SF424 R&R form. Applications without this information in box 4B will not be considered for this initiative.

Applications nonresponsive to terms of this NOSI will not be considered for the NOSI initiative.


Please direct all inquiries to the contacts in Section VII of the listed funding opportunity announcements with the following additions/substitutions:

Scientific/Research Contact(s)

Shimian Zou, PhD
National Heart, Lung, and Blood Institute (NHLBI)
Telephone: 301-827-8301


Peer Review Contact(s)

Examine your eRA Commons account for review assignment and contact information (information appears two weeks after the submission due date).


Financial/Grants Management Contact(s)

Fatima Kamara
National Heart, Lung, and Blood Institute
Telephone: 301-435-7916

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