| Publication Abstract Display | | Type: Published Abstract | | Title: A combined index of age, HIV biomarkers, and medical comorbidities is associated with neurocognitive impairment in HIV disease. | | Authors: Marquine M, Moore DJ, Gouaux B, Rooney A, Woods SP, Letendre SL, Ellis RJ, Grant I, and the HNRP Group | | Year: 2013 | | Publication: 121st Annual Convention of the American Psychological Association | | Volume: Issue: Pages: | | Abstract:Objective: Antiretroviral therapy has transformed HIV into a chronic disease. As a result, this population is aging, and the impact of comorbidities and multiple organ system dysfunction on patients’ health has become a research focus. We evaluated the association between neurocognitive impairment (NCI) and the Veterans Aging Cohort Study (VACS) Index, which integrates age, traditional HIV biomarkers (plasma HIV-1 RNA and current CD4 count), and non-HIV biomarkers (i.e., indicators of renal and liver function, anemia, and Hepatitis C).
Participants and Methods: Participants included 1274 HIV+ adults enrolled in various studies at the UCSD HIV Neurobehavioral Research Program (Ages 18-76 years; 85% male; 53% White; Median current CD4=370; 67% on ART; AIDS=64%, detectable plasma viral load=56%). We computed the VACS Index and divided our sample into those with high (upper quartile, n=325) and low (lower quartile, n=335) VACS Index scores. Neurocognitive functioning was assessed with a comprehensive battery; NCI was defined using a global and domain deficit scores derived from demographically-corrected T-scores.
Results: The High VACS group had significantly higher rates of global NCI than the Low VACS group (56% vs. 35%; χ2=28.08, p<.001). Similarly, a series of Chi-Square tests revealed that the High VACS group had significantly higher rates of NCI across all cognitive domains (all ps<.01), except for verbal fluency (p=.11). Effect sizes on continuous cognitive deficit scores were small to moderate (Cohen’s d range=.31-.54). A logistic regression model predicting NCI was significant (p<.001) and showed that both VACS group (χ2=13.01, p<.001) and AIDS (χ2=5.26, p=.02) were significant predictors.
Conclusion: High VACS Index scores and AIDS status were associated with NCI. These results support recent findings of multiple interacting causes of brain dysfunction in persons with HIV. Future studies will seek to determine the VACS components most sensitive to NCI in HIV. |
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