Publication Abstract Display
Type: Published Manuscript
Title: Anemia and red cell indices predict HIV-associated neurocognitive impairment in the HAART Era.
Authors: Kallianpur AR, Wang Q, Jia P, Hulgan T, Zhao Z, Letendre SL, Ellis RJ, Heaton RK, Franklin DR, Barnholtz-Sloan J, Collier AC, Marra CM, Clifford DB, Gelman BB, McArthur JC, Morgello S, Simpson DM, McCutchan J A, Grant Igor
Year: 2016
Publication: The Journal of Infectious Diseases
Volume: 213 Issue: 7 Pages: 1065-1073
Abstract:BACKGROUND:  Anemia has been linked to adverse HIV outcomes, including dementia, in the pre-highly active antiretroviral therapy (HAART) era. Milder forms of HIV-associated neurocognitive disorder (HAND) remain common in HIV-infected persons, despite HAART, but whether anemia predicts HAND in the HAART era is unknown. METHODS:  We evaluated time-dependent associations of anemia and cross-sectional associations of red cell indices with neurocognitive impairment in a multi-center, HAART-era HIV cohort study (N=1261), adjusting for potential confounders, including age, nadir CD4+ T-cell count, zidovudine use and comorbidities. Subjects underwent comprehensive neuropsychiatric and neuromedical assessments. RESULTS:  HAND, defined by standardized criteria, occurred in 595 subjects (47%) at entry. Mean corpuscular volume (MCV) and mean corpuscular hemoglobin (MCH) were positively associated with the Global Deficit Score, a continuous measure of neurocognitive impairment (both p<0.01), as well as with all HAND, milder forms of HAND, and HIV-associated dementia in multivariable analyses (all p<0.05). Anemia independently predicted development of HAND during a median follow-up of 72 months (adjusted HR 1.55 p<0.01). CONCLUSIONS:  Anemia and red cell indices predict HAND in the HAART era and may contribute to risk assessment. Future studies should address whether treating anemia may help to prevent HAND or improve cognitive function in HIV-infected persons.

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