BACKGROUND: Risk of cognitive impairment is increased among persons with high or low body mass index in HIV- and HIV+ populations in resource-rich settings. We examined this association among HIV+ patients in 3 resource-limited settings. METHODS: This secondary analysis included data of 761 HIV+ volunteers pooled from 3 prospective cohort studies conducted in China (n = 404; 53%), India (n = 200; 26%), and Nigeria (n = 157; 21%). World Health Organization (WHO) weight classifications were based on body mass index. T scores, adjusted for demographics and practice effects, were derived from a 7-domain neuropsychological battery. Neurocognitive impairment (NCI) was defined as global deficit score of ≥0.5. RESULTS: Overall, prevalence of NCI at baseline was 27.7% (similar across all cohorts). The overweight/obese and underweight constituted 37.3% and 15.5% of the total participants, respectively. In a multivariable logistic regression of pooled longitudinal data, adjusting for clinical and demographic variables, the odds of global NCI were 38% higher among the overweight/obese as compared to normal weight participants [odds ratio: 1.38 (95% confidence interval: 1.1 to 1.72); P = 0.005]. Similarly, the odds of global NCI were 39% higher among the underweight as compared to normal weight participants [odds ratio: 1.39 (95% confidence interval: 1.03 to 1.87); P = 0.029]. CONCLUSIONS: NCI among HIV-1-infected patients was more prevalent in both overweight/obese and underweight than normal weight individuals in 3 resource-limited settings, confirming observations in resource-rich settings. Mechanisms underlying these associations are unclear but likely differ for underweight and overweight persons.
BACKGROUND: Risk of cognitive impairment is increased among persons with high or low body mass index in HIV- and HIV+ populations in resource-rich settings. We examined this association among HIV+ patients in 3 resource-limited settings. METHODS: This secondary analysis included data of 761 HIV+ volunteers pooled from 3 prospective cohort studies conducted in China (n = 404; 53%), India (n = 200; 26%), and Nigeria (n = 157; 21%). World Health Organization (WHO) weight classifications were based on body mass index. T scores, adjusted for demographics and practice effects, were derived from a 7-domain neuropsychological battery. Neurocognitive impairment (NCI) was defined as global deficit score of ≥0.5. RESULTS: Overall, prevalence of NCI at baseline was 27.7% (similar across all cohorts). The overweight/obese and underweight constituted 37.3% and 15.5% of the total participants, respectively. In a multivariable logistic regression of pooled longitudinal data, adjusting for clinical and demographic variables, the odds of global NCI were 38% higher among the overweight/obese as compared to normal weight participants [odds ratio: 1.38 (95% confidence interval: 1.1 to 1.72); P = 0.005]. Similarly, the odds of global NCI were 39% higher among the underweight as compared to normal weight participants [odds ratio: 1.39 (95% confidence interval: 1.03 to 1.87); P = 0.029]. CONCLUSIONS:NCI among HIV-1-infectedpatients was more prevalent in both overweight/obese and underweight than normal weight individuals in 3 resource-limited settings, confirming observations in resource-rich settings. Mechanisms underlying these associations are unclear but likely differ for underweight and overweight persons.
Authors: J A McCutchan; J A Marquie-Beck; C A Fitzsimons; S L Letendre; R J Ellis; R K Heaton; T Wolfson; D Rosario; T J Alexander; C Marra; B M Ances; I Grant Journal: Neurology Date: 2012-02-14 Impact factor: 9.910
Authors: Philip A Wolf; Alexa Beiser; Merrill F Elias; Rhoda Au; Ramachandran S Vasan; Sudha Seshadri Journal: Curr Alzheimer Res Date: 2007-04 Impact factor: 3.498
Authors: Kristine Yaffe; Alka Kanaya; Karla Lindquist; Eleanor M Simonsick; Tamara Harris; Ronald I Shorr; Frances A Tylavsky; Anne B Newman Journal: JAMA Date: 2004-11-10 Impact factor: 56.272
Authors: Anna Dahl; Linda B Hassing; Eleonor Fransson; Stig Berg; Margaret Gatz; Chandra A Reynolds; Nancy L Pedersen Journal: J Gerontol A Biol Sci Med Sci Date: 2009-04-06 Impact factor: 6.053
Authors: Jibreel Jumare; Samer S El-Kamary; Laurence Magder; Laura Hungerford; Nicaise Ndembi; Ahmad Aliyu; Patrick Dakum; Anya Umlauf; Mariana Cherner; Alash'le Abimiku; Man Charurat; William A Blattner; Walter Royal Journal: J Neurovirol Date: 2018-08-30 Impact factor: 2.643
Authors: Thomas D Marcotte; Reena Deutsch; Benedict Daniel Michael; Donald Franklin; Debra Rosario Cookson; Ajay R Bharti; Igor Grant; Scott L Letendre Journal: J Neuroimmune Pharmacol Date: 2013-10-08 Impact factor: 4.147
Authors: Leah H Rubin; Deborah Gustafson; Kellie L Hawkins; Long Zhang; Lisa P Jacobson; James T Becker; Cynthia A Munro; Jordan E Lake; Eileen Martin; Andrew Levine; Todd T Brown; Ned Sacktor; Kristine M Erlandson Journal: Neurology Date: 2019-06-14 Impact factor: 11.800