Publication Abstract Display
Type: Published Manuscript
Title: Neurocognitive impact of substance use in HIV infection.
Authors: Byrd DA, Fellows RP, Morgello S, Franklin D, Heaton RK, Deutsch R, Atkinson JA, Clifford DB, Collier AC, Marra C, Gelman B, McCutchan JA, Duarte NA, Simpson D, McArthur J, Grant I, and the CHARTER Group
Year: 2011
Publication: Journal of Acquired Immune Deficiency Syndromes
Volume: 58 Issue: 2 Pages: 154-162
Abstract:BACKGROUND: To determine how serious a confound substance use (SU) might be in studies on HIV-associated neurocognitive disorder (HAND) we examined the relationship of SU history to neurocognitive impairment (NCI) in participants enrolled in the CNS HIV Antiretroviral Therapy Effects Research (CHARTER) study. METHODS: After excluding cases with behavioral evidence of acute intoxication and histories of factors that independently could account for NCI (e.g., stroke), baseline demographic, medical, SU, and neurocognitive data were analyzed from 399 participants. Potential SU risk for NCI was determined by the following criteria: lifetime SU DSM-IV diagnosis, self-report of marked lifetime SU, or positive urine toxicology (UTOX). Participants were divided into three groups: no SU (N = 134), subNon-syndromic SU (N = 131), syndromic SU (N = 134) and matched on literacy level, nadir CD4, and depressive symptoms. RESULTS: While approximately 50% of the participants were diagnosed with HAND, a MANCOVA of NC summary scores, covarying for UTOX, revealed no significant effect of SU status. Correlational analyses indicated weak associations between lifetime heroin dosage and poor recall and working memory, as well as between cannabis and cocaine use and better verbal fluency. CONCLUSIONS: These data indicate that HIV neurocognitive effects are seen at about the same frequency in those with and without historic substance abuse, in cases that are equated on other factors that might contribute to NCI. Therefore, studies on neuroAIDS and its treatment need not exclude such cases. However, the effects of acute SU and current SU disorders on HAND require further study.

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