| Publication Abstract Display | | Type: Published Abstract | | Title: Aging amplifies HIV neurocognitive impairment. | | Authors: Heaton RK, Franklin D, Letendre SL, Ellis RJ, Fennema-Notestine C, Vaida F, Smith D, Collier A, Marra C, Clifford D, Gelman B, Sacktor N, Morgello S, Simpson D, McCutchan JA, Grant I, for the CHARTER Group | | Year: 2015 | | Publication: HIV & Aging Conference | | Volume: Issue: Pages: | | Abstract:Introduction: Modern antiretroviral therapy (ART) has substantially extended the survival of HIV infected persons into their later years, raising the possibility that age-related organ changes, including neurodegenerative and cerebrovascular changes, might amplify HIV effects on the brain. This study investigated the effects of age, HIV, and vascular and metabolic markers on neurocognitive (NC) function.
Materials & Methods: 843 HIV+ participants from the CHARTER study along with 677 HIV+ and 377 HIV- participants from the HNRP were selected for analysis. Subjects received comprehensive neuromedical, neurocognitive, and laboratory assessments. Logistic regression was used to examine the effects of age and HIV disease variables on global and domain specific cognitive function. Interactions between age and HIV disease and vascular markers were also modeled in analyses of HIV+ participants.
Results: Using scaled scores, HIV+ cases performed worse than HIV- in all domains and globally (all p<.01). There were significant age x HIV interactions with older HIV+ performing incrementally worse in the executive, speed of information processing, working memory, learning and memory domains as well as globally (all p<.01). Exploratory analyses of HIV disease markers showed age interactions with AIDS diagnosis and a main effect for nadir CD4 on global deficit score. Current CD4, ART status, and plasma viral load were not related to NC performance.
Conclusions: Our results show disproportionate reduction in neurocognitive performance in HIV+ persons as they age, and that both AIDS diagnosis and nadir CD4 may play a role in amplifying these effects. |
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