Saurabh Gupta1, Jennifer E Iudicello2, Chuan Shi3, Scott Letendre2, Adam Knight2, Jianhua Li4, Patricia K Riggs2, Donald R Franklin2, Nichole Duarte1, Hua Jin5, J Hampton Atkinson6, Xin Yu3, Zunyou Wu7, Igor Grant2, Robert K Heaton8. 1. HIV Neurobehavioral Research Program (HNRP), University of California San Diego, CA, USA; Gupta Psychology & Assessment Services, USA. 2. HIV Neurobehavioral Research Program (HNRP), University of California San Diego, CA, USA. 3. The Institute of Mental Health at Peking University, Beijing, China. 4. China Yunnan Institute of Drug Abuse, Kunming, China. 5. HIV Neurobehavioral Research Program (HNRP), University of California San Diego, CA, USA; VA San Diego Healthcare System, San Diego, CA, USA. 6. VA San Diego Healthcare System, San Diego, CA, USA; HIV Neurobehavioral Research Program (HNRP), University of California San Diego, CA, USA. 7. China Centers for Disease Control (China CDC), Beijing, China. 8. HIV Neurobehavioral Research Program (HNRP), University of California San Diego, CA, USA. Electronic address: rheaton@ucsd.edu.
Abstract
BACKGROUND: Prior research has demonstrated neuropsychological (NP) impairment in persons with histories of injection drug use (IDU), hepatitis C virus (HCV) infection, and methadone maintenance treatment (MMT), individually, but little is known about the NP effects of these three risk factors in combination. This issue is particularly important in China, which is addressing its highly HCV-comorbid IDU epidemic with widespread government sponsored MMT, especially in light of recent evidence suggesting that methadone may be neuroprotective in some circumstances. METHODS: We administered a comprehensive NP test battery to 195 Chinese heroin IDU individuals taking MMT (IDU+ group), the majority of whom were also HCV+ (87%; n=169), and compared their NP performance to that of 198 demographically comparable, non-IDU Chinese controls (IDU- group). All participants in both groups tested negative for HIV infection, which is also a common comorbidity in the Chinese IDU population. RESULTS: The IDU+ group did not have an increased rate of global NP impairment, or perform significantly worse on any individual NP test measure. Within the IDU+ group, liver disease characteristics and reported details of heroin use were not significantly associated with NP performance. CONCLUSION: Failure to detect NP impairment in IDU+ subjects with or without HCV infection was surprising, particularly considering the previously demonstrated sensitivity of our NP battery to neurocognitive disorders associated with HIV infection in China. One possible explanation, which should be explored in future research, is the potential neuroprotective effect of methadone in the context of HCV infection and/or heroin withdrawal.
BACKGROUND: Prior research has demonstrated neuropsychological (NP) impairment in persons with histories of injection drug use (IDU), hepatitis C virus (HCV) infection, and methadone maintenance treatment (MMT), individually, but little is known about the NP effects of these three risk factors in combination. This issue is particularly important in China, which is addressing its highly HCV-comorbid IDU epidemic with widespread government sponsored MMT, especially in light of recent evidence suggesting that methadone may be neuroprotective in some circumstances. METHODS: We administered a comprehensive NP test battery to 195 Chinese heroinIDU individuals taking MMT (IDU+ group), the majority of whom were also HCV+ (87%; n=169), and compared their NP performance to that of 198 demographically comparable, non-IDU Chinese controls (IDU- group). All participants in both groups tested negative for HIV infection, which is also a common comorbidity in the Chinese IDU population. RESULTS: The IDU+ group did not have an increased rate of global NP impairment, or perform significantly worse on any individual NP test measure. Within the IDU+ group, liver disease characteristics and reported details of heroin use were not significantly associated with NP performance. CONCLUSION: Failure to detect NP impairment in IDU+ subjects with or without HCV infection was surprising, particularly considering the previously demonstrated sensitivity of our NP battery to neurocognitive disorders associated with HIV infection in China. One possible explanation, which should be explored in future research, is the potential neuroprotective effect of methadone in the context of HCV infection and/or heroin withdrawal.
Authors: Lucette A Cysique; Scott L Letendre; Christopher Ake; Hua Jin; Donald R Franklin; Saurabh Gupta; Chuan Shi; Xin Yu; Zunyou Wu; Ian S Abramson; Igor Grant; Robert K Heaton Journal: AIDS Date: 2010-04-24 Impact factor: 4.177
Authors: F Maggi; C Fornai; A Morrica; M L Vatteroni; M Giorgi; S Marchi; P Ciccorossi; M Bendinelli; M Pistello Journal: J Med Virol Date: 1999-01 Impact factor: 2.327
Authors: A K Njamnshi; A C Zoung-Kanyi Bissek; P Ongolo-Zogo; E N Tabah; A Z Lekoubou; F N Yepnjio; J Y Fonsah; C T Kuate; S A Angwafor; F Dema; D M Njamnshi; C Kouanfack; V de P Djientcheu; W F T Muna; G D Kanmogne Journal: J Neurol Sci Date: 2009-07-24 Impact factor: 3.181
Authors: Christy A Denckla; Georgina Spies; Robert Heaton; Jennifer Vasterling; Donald Franklin; Kristina J Korte; Courtney Colgan; David C Henderson; Karestan C Koenen; Soraya Seedat Journal: Clin Neuropsychol Date: 2019-04-05 Impact factor: 3.535
Authors: Jerel Adam Fields; Wilmar Dumaop; Leslie Crews; Anthony Adame; Brian Spencer; Jeff Metcalf; Johnny He; Edward Rockenstein; Eliezer Masliah Journal: Curr HIV Res Date: 2015 Impact factor: 1.581
Authors: Tyler R C Day; Davey M Smith; Robert K Heaton; Donald Franklin; Myers W Tilghman; Scott Letendre; Hua Jin; Zunyou Wu; Chuan Shi; Xin Yu; Josué Pérez-Santiago Journal: J Neurovirol Date: 2015-08-26 Impact factor: 2.643