Associations of cardiovascular variables and HAART with cognition in middle-aged HIV-infected and uninfected women

Howard A. Crystal, Jeremy Weedon, Susan Holman, Jennifer Manly, Victor Valcour, Mardge Cohen, Kathryn Anastos, Chenglong Liu, Wendy J. Mack, Elizabeth Golub, Jason Lazar, Ann Ho, Mary Jeanne Kreek, Robert C. Kaplan

Research output: Contribution to journalArticle

15 Scopus citations

Abstract

Despite the use of highly active anti-retroviral treatment (HAART), cognitive impairment remains prevalent in HIV. Indeed a recent study suggested that in certain instances, stopping HAART was associated with improved cognitive function (Robertson et al. Neurology 74(16):1260-1266 2010). HAART is occasionally associated with cardiovascular pathology and such pathology may be associated with cognitive impairment. To explore these associations, we assessed the relative contributions of cardiovascular variables such as hypertension and atherosclerosis, of HIV and HAART to cognition. The participants were members of the Women's Interagency HIV Study. In the analysis of cross-sectional data using general linear models, we assessed the relationship between each cardiovascular variable and Stroop interference time and symbol digit modalities test while adjusting for age, HIV, education, depression, and race/ethnicity. We also analyzed the association of summary measures of HAART use with cognition. In multivariate models, significance was limited to carotid lesions and carotid intima-medial thickness quintile (CIMT) with Stroop interference time (for carotid lesions, coefficient=10.5, CI 3.5 to 17.5, p=0.003, N=1,130; for CIMT quintile, coefficient=8.6, CI=1.7 to 15.4, p=0.025, N=1,130). The summary measures of protease inhibitor use and other HAART measures were in most cases not associated with cognitive score in multivariate models. We conclude that in the HAART era among middle-aged women with HIV, carotid disease may be significantly associated with some measures of cognitive impairment. In this crosssectional study, we could detect neither positive nor negative effects of HAART on cognition.

Original languageEnglish (US)
Pages (from-to)469-476
Number of pages8
JournalJournal of NeuroVirology
Volume17
Issue number5
DOIs
StatePublished - Oct 1 2011

    Fingerprint

Keywords

  • Atherosclerosis
  • Cognition
  • HIV
  • Hypertension
  • Middle-aged
  • Women

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology
  • Cellular and Molecular Neuroscience
  • Virology

Cite this

Crystal, H. A., Weedon, J., Holman, S., Manly, J., Valcour, V., Cohen, M., Anastos, K., Liu, C., Mack, W. J., Golub, E., Lazar, J., Ho, A., Kreek, M. J., & Kaplan, R. C. (2011). Associations of cardiovascular variables and HAART with cognition in middle-aged HIV-infected and uninfected women. Journal of NeuroVirology, 17(5), 469-476. https://doi.org/10.1007/s13365-011-0052-3