Cognitive trajectories over 4 years among HIV-infected women with optimal viral suppression

Leah H. Rubin, Pauline M. Maki, Gayle Springer, Lorie Benning, Kathryn Anastos, Deborah Gustafson, Maria C. Villacres, Xiong Jiang, Adaora A. Adimora, Drenna Waldrop-Valverde, David E. Vance, Hector Bolivar, Christine Alden, Eileen M. Martin, Victor G. Valcour

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Objective: To determine whether persistent viral suppression alters cognitive trajectories among HIV-infected (HIV+) women on combination antiretroviral therapy (cART) by investigating performance longitudinally in uninfected (HIV-) and 3 groups of HIV+ women: Those with consistent viral suppression after continuous cART use (VS), those without consistent virologic suppression despite continuous cART use (NVS), and those without consistent virologic suppression after intermittent cART use (Int NVS). Methods: Two hundred thirty-nine VS, 220 NVS, 172 Int NVS, and 301 HIV-women from the Women's Interagency HIV Study (WIHS) completed neuropsychological testing every 2 years for 3 visits between 2009 and 2013. Mixed-effects regressions were used to examine group differences on continuous T scores and categorical measures of impairment (T score <40). Results: On global function, VS women demonstrated lower scores and were more likely to score in the impaired range than HIV-women (p = 0.01). These differences persisted over time (group × time, p > 0.39). VS women demonstrated lower learning and memory scores than HIV-women (p < 0.05) and lower attention/working memory and fluency scores than HIV- A nd NVS women (p < 0.05). Group differences in scores persisted over time. Categorically, VS women were more likely to be impaired on attention/working memory and executive function than HIV-women (p < 0.05). On motor skills, VS and NVS women showed a greater decline and were more likely to be impaired than HIV-women (p < 0.05). Conclusions: Cognitive difficulties remain among HIV+ women despite persistent viral suppression. In some instances, VS women are worse than NVS women, reinforcing the need for novel adjunctive therapies to attenuate cognitive problems.

Original languageEnglish (US)
Pages (from-to)1594-1603
Number of pages10
JournalNeurology
Volume89
Issue number15
DOIs
StatePublished - Oct 10 2017
Externally publishedYes

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HIV
Short-Term Memory
Therapeutics
Motor Skills
Executive Function
Learning

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

Rubin, L. H., Maki, P. M., Springer, G., Benning, L., Anastos, K., Gustafson, D., ... Valcour, V. G. (2017). Cognitive trajectories over 4 years among HIV-infected women with optimal viral suppression. Neurology, 89(15), 1594-1603. https://doi.org/10.1212/WNL.0000000000004491

Cognitive trajectories over 4 years among HIV-infected women with optimal viral suppression. / Rubin, Leah H.; Maki, Pauline M.; Springer, Gayle; Benning, Lorie; Anastos, Kathryn; Gustafson, Deborah; Villacres, Maria C.; Jiang, Xiong; Adimora, Adaora A.; Waldrop-Valverde, Drenna; Vance, David E.; Bolivar, Hector; Alden, Christine; Martin, Eileen M.; Valcour, Victor G.

In: Neurology, Vol. 89, No. 15, 10.10.2017, p. 1594-1603.

Research output: Contribution to journalArticle

Rubin, LH, Maki, PM, Springer, G, Benning, L, Anastos, K, Gustafson, D, Villacres, MC, Jiang, X, Adimora, AA, Waldrop-Valverde, D, Vance, DE, Bolivar, H, Alden, C, Martin, EM & Valcour, VG 2017, 'Cognitive trajectories over 4 years among HIV-infected women with optimal viral suppression', Neurology, vol. 89, no. 15, pp. 1594-1603. https://doi.org/10.1212/WNL.0000000000004491
Rubin, Leah H. ; Maki, Pauline M. ; Springer, Gayle ; Benning, Lorie ; Anastos, Kathryn ; Gustafson, Deborah ; Villacres, Maria C. ; Jiang, Xiong ; Adimora, Adaora A. ; Waldrop-Valverde, Drenna ; Vance, David E. ; Bolivar, Hector ; Alden, Christine ; Martin, Eileen M. ; Valcour, Victor G. / Cognitive trajectories over 4 years among HIV-infected women with optimal viral suppression. In: Neurology. 2017 ; Vol. 89, No. 15. pp. 1594-1603.
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T1 - Cognitive trajectories over 4 years among HIV-infected women with optimal viral suppression

AU - Rubin, Leah H.

AU - Maki, Pauline M.

AU - Springer, Gayle

AU - Benning, Lorie

AU - Anastos, Kathryn

AU - Gustafson, Deborah

AU - Villacres, Maria C.

AU - Jiang, Xiong

AU - Adimora, Adaora A.

AU - Waldrop-Valverde, Drenna

AU - Vance, David E.

AU - Bolivar, Hector

AU - Alden, Christine

AU - Martin, Eileen M.

AU - Valcour, Victor G.

PY - 2017/10/10

Y1 - 2017/10/10

N2 - Objective: To determine whether persistent viral suppression alters cognitive trajectories among HIV-infected (HIV+) women on combination antiretroviral therapy (cART) by investigating performance longitudinally in uninfected (HIV-) and 3 groups of HIV+ women: Those with consistent viral suppression after continuous cART use (VS), those without consistent virologic suppression despite continuous cART use (NVS), and those without consistent virologic suppression after intermittent cART use (Int NVS). Methods: Two hundred thirty-nine VS, 220 NVS, 172 Int NVS, and 301 HIV-women from the Women's Interagency HIV Study (WIHS) completed neuropsychological testing every 2 years for 3 visits between 2009 and 2013. Mixed-effects regressions were used to examine group differences on continuous T scores and categorical measures of impairment (T score <40). Results: On global function, VS women demonstrated lower scores and were more likely to score in the impaired range than HIV-women (p = 0.01). These differences persisted over time (group × time, p > 0.39). VS women demonstrated lower learning and memory scores than HIV-women (p < 0.05) and lower attention/working memory and fluency scores than HIV- A nd NVS women (p < 0.05). Group differences in scores persisted over time. Categorically, VS women were more likely to be impaired on attention/working memory and executive function than HIV-women (p < 0.05). On motor skills, VS and NVS women showed a greater decline and were more likely to be impaired than HIV-women (p < 0.05). Conclusions: Cognitive difficulties remain among HIV+ women despite persistent viral suppression. In some instances, VS women are worse than NVS women, reinforcing the need for novel adjunctive therapies to attenuate cognitive problems.

AB - Objective: To determine whether persistent viral suppression alters cognitive trajectories among HIV-infected (HIV+) women on combination antiretroviral therapy (cART) by investigating performance longitudinally in uninfected (HIV-) and 3 groups of HIV+ women: Those with consistent viral suppression after continuous cART use (VS), those without consistent virologic suppression despite continuous cART use (NVS), and those without consistent virologic suppression after intermittent cART use (Int NVS). Methods: Two hundred thirty-nine VS, 220 NVS, 172 Int NVS, and 301 HIV-women from the Women's Interagency HIV Study (WIHS) completed neuropsychological testing every 2 years for 3 visits between 2009 and 2013. Mixed-effects regressions were used to examine group differences on continuous T scores and categorical measures of impairment (T score <40). Results: On global function, VS women demonstrated lower scores and were more likely to score in the impaired range than HIV-women (p = 0.01). These differences persisted over time (group × time, p > 0.39). VS women demonstrated lower learning and memory scores than HIV-women (p < 0.05) and lower attention/working memory and fluency scores than HIV- A nd NVS women (p < 0.05). Group differences in scores persisted over time. Categorically, VS women were more likely to be impaired on attention/working memory and executive function than HIV-women (p < 0.05). On motor skills, VS and NVS women showed a greater decline and were more likely to be impaired than HIV-women (p < 0.05). Conclusions: Cognitive difficulties remain among HIV+ women despite persistent viral suppression. In some instances, VS women are worse than NVS women, reinforcing the need for novel adjunctive therapies to attenuate cognitive problems.

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