TY - JOUR
T1 - Associations of cardiovascular variables and HAART with cognition in middle-aged HIV-infected and uninfected women
AU - Crystal, Howard A.
AU - Weedon, Jeremy
AU - Holman, Susan
AU - Manly, Jennifer
AU - Valcour, Victor
AU - Cohen, Mardge
AU - Anastos, Kathryn
AU - Liu, Chenglong
AU - Mack, Wendy J.
AU - Golub, Elizabeth
AU - Lazar, Jason
AU - Ho, Ann
AU - Kreek, Mary Jeanne
AU - Kaplan, Robert C.
N1 - Copyright:
Copyright 2012 Elsevier B.V., All rights reserved.
PY - 2011/10
Y1 - 2011/10
N2 - 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.
AB - 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.
KW - Atherosclerosis
KW - Cognition
KW - HIV
KW - Hypertension
KW - Middle-aged
KW - Women
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U2 - 10.1007/s13365-011-0052-3
DO - 10.1007/s13365-011-0052-3
M3 - Article
C2 - 22006469
AN - SCOPUS:84862944922
VL - 17
SP - 469
EP - 476
JO - Journal of NeuroVirology
JF - Journal of NeuroVirology
SN - 1355-0284
IS - 5
ER -