A Winston1, W Stöhr2, A Antinori3, A Arenas-Pinto2, J M Llibre4,5, H Amieva6, A Cabié7, I Williams8, G Di Perri9,10, M J Tellez11, J Rockstroh12, A Babiker2, A Pozniak13, F Raffi14, L Richert6,15. 1. Department of Medicine, Imperial College London, London, UK. 2. MRC Clinical Trials Unit at University College London, London, UK. 3. Clinical Department, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, Rome, Italy. 4. HIV Unit and Lluita contra la SIDA Foundation, University Hospital Germans Trias i Pujol, Badalona, Spain. 5. Universitat Autonoma de Barcelona, Barcelona, Spain. 6. Centre Inserm U897-Epidemiologie-Biostatistique, University of Bordeaux, ISPED, Bordeaux, France. 7. Department of Infectious and Tropical Diseases and INSERM CIE802, University Hospital of Fort-de-France, Fort-de-France, Martinique, France. 8. Centre for Sexual Health and HIV Research, Mortimer Market Centre, University College London, London, UK. 9. Laboratory of Clinical Pharmacology and Pharmacogenetics (2), Unit of Infectious Diseases, University of Turin, Turin, Italy. 10. Department of Medical Sciences, Amedeo di Savoia Hospital, Turin, Italy. 11. Infectious Diseases Unit, Internal Medicine, Hospital Clinico Universitario, Madrid, Spain. 12. Department of General Internal Medicine I, University Hospital of Bonn, Bonn, Germany. 13. Chelsea and Westminster NHS Foundation Trust, London, UK. 14. CMIT, Paris, France. 15. CHU de Bordeaux, Pole de sante publique, and CIC1401-EC (Clinical Epidemiology), Bordeaux, France.
Abstract
OBJECTIVES: Deficits in cognitive function remain prevalent in HIV-infected individuals. The aim of this European multicentre study was to assess factors associated with cognitive function in antiretroviral therapy (ART)-naïve HIV-infected subjects at the time of enrolment in the NEAT 001/Agence Nationale de Recherche sur le SIDA (ANRS) 143 study. METHODS: Prior to starting ART, seven cognitive tests exploring domains including episodic memory, verbal fluency, executive function and psychomotor speed were administered with scores standardized to z-score using the study population sample mean and standard deviation. The primary measure was overall z-score average (NPZ). We assessed associations between baseline factors and test results using multivariable regression models. RESULTS: Of 283 subjects with baseline cognitive assessments, 90% were male and 12% of black ethnicity. Median (interquartile range) age, years of education, years of known HIV infection, baseline CD4 count and baseline HIV RNA were 39 (31, 47) years, 13 (11, 17) years, 1 (0, 4) years, 344 (279, 410) cells/μL and 4.74 (4.28, 5.14) log10 HIV-1 RNA copies/mL, respectively. Forty per cent were current smokers. Factors significantly associated with poorer overall cognitive performance in multivariable models included older age, shorter duration of education, black ethnicity, lower height, and lower plasma HIV RNA. CONCLUSIONS: In this large, European-wide, ART-naïve population with relatively preserved immunity and early HIV infection, cognitive function scores at the time of ART initiation were associated with demographic and HIV-disease factors.
OBJECTIVES: Deficits in cognitive function remain prevalent in HIV-infected individuals. The aim of this European multicentre study was to assess factors associated with cognitive function in antiretroviral therapy (ART)-naïve HIV-infected subjects at the time of enrolment in the NEAT 001/Agence Nationale de Recherche sur le SIDA (ANRS) 143 study. METHODS: Prior to starting ART, seven cognitive tests exploring domains including episodic memory, verbal fluency, executive function and psychomotor speed were administered with scores standardized to z-score using the study population sample mean and standard deviation. The primary measure was overall z-score average (NPZ). We assessed associations between baseline factors and test results using multivariable regression models. RESULTS: Of 283 subjects with baseline cognitive assessments, 90% were male and 12% of black ethnicity. Median (interquartile range) age, years of education, years of known HIV infection, baseline CD4 count and baseline HIV RNA were 39 (31, 47) years, 13 (11, 17) years, 1 (0, 4) years, 344 (279, 410) cells/μL and 4.74 (4.28, 5.14) log10 HIV-1 RNA copies/mL, respectively. Forty per cent were current smokers. Factors significantly associated with poorer overall cognitive performance in multivariable models included older age, shorter duration of education, black ethnicity, lower height, and lower plasma HIV RNA. CONCLUSIONS: In this large, European-wide, ART-naïve population with relatively preserved immunity and early HIV infection, cognitive function scores at the time of ART initiation were associated with demographic and HIV-disease factors.
Authors: Chao-Jiang Gu; Alejandra Borjabad; Eran Hadas; Jennifer Kelschenbach; Boe-Hyun Kim; Wei Chao; Ottavio Arancio; Jin Suh; Bruce Polsky; JoEllyn McMillan; Benson Edagwa; Howard E Gendelman; Mary Jane Potash; David J Volsky Journal: PLoS Pathog Date: 2018-06-07 Impact factor: 6.823