Nina Pocuca1, Jared W Young2, David A MacQueen2, Scott Letendre3, Robert K Heaton3, Mark A Geyer2, William Perry3, Igor Grant3, Arpi Minassian4. 1. Department of Psychiatry, University of California San Diego, 9500 Gilman Drive MC 0804, La Jolla, CA, 92093-0804, United States. Electronic address: npocuca@ucsd.edu. 2. Department of Psychiatry, University of California San Diego, 9500 Gilman Drive MC 0804, La Jolla, CA, 92093-0804, United States; Desert-Pacific Mental Illness Research Education and Clinical Center, VA San Diego Healthcare System, San Diego, CA, United States. 3. Department of Psychiatry, University of California San Diego, 9500 Gilman Drive MC 0804, La Jolla, CA, 92093-0804, United States. 4. Department of Psychiatry, University of California San Diego, 9500 Gilman Drive MC 0804, La Jolla, CA, 92093-0804, United States; VA Center of Excellence for Stress and Mental Health, Veterans Administration San Diego HealthCare System, 3350 La Jolla Village Drive, San Diego, CA, 92161, United States.
Abstract
BACKGROUND: Human immunodeficiency virus (HIV)-associated neurocognitive disorders persist in the era of antiretroviral therapy. One factor that is elevated among persons with HIV (PWH) and independently associated with neurocognitive impairment is methamphetamine dependence (METH). Such dependence may further increase cognitive impairment among PWH, by delaying HIV diagnosis (and thus, antiretroviral therapy initiation), which has been posited to account for persistent cognitive impairment among PWH, despite subsequent treatment-related viral load suppression (VLS; <50 copies of the virus per milliliter in plasma or cerebrospinal fluid). This study examined the main and interactive (additive versus synergistic) effects of HIV and history of METH on the sustained attention and vigilance cognitive domain, while controlling for VLS. METHODS: Participants included 205 (median age = 44 years; 77% males; HIV-/METH- n = 67; HIV+/METH - n = 49; HIV-/METH+ n = 36; HIV+/METH+ n = 53) individuals enrolled in the Translational Methamphetamine AIDS Research Center, who completed Conners' and the 5-Choice continuous performance tests (CPTs). RESULTS: METH participants exhibited deficits in sustained attention and vigilance; however, these effects were not significant after excluding participants who had a positive urine toxicology screen for methamphetamine. Controlling for VLS, PWH did not have worse sustained attention and vigilance, but consistently displayed slower reaction times across blocks, relative to HIV- participants. There was no HIV x METH interaction on sustained attention and vigilance. CONCLUSIONS: Recent methamphetamine use among METH people and detectable viral loads are detrimental to sustained attention and vigilance. These findings highlight the need for prompt diagnosis of HIV and initiation of antiretroviral therapy, and METH use interventions.
BACKGROUND:Humanimmunodeficiency virus (HIV)-associated neurocognitive disorders persist in the era of antiretroviral therapy. One factor that is elevated among persons with HIV (PWH) and independently associated with neurocognitive impairment is methamphetamine dependence (METH). Such dependence may further increase cognitive impairment among PWH, by delaying HIV diagnosis (and thus, antiretroviral therapy initiation), which has been posited to account for persistent cognitive impairment among PWH, despite subsequent treatment-related viral load suppression (VLS; <50 copies of the virus per milliliter in plasma or cerebrospinal fluid). This study examined the main and interactive (additive versus synergistic) effects of HIV and history of METH on the sustained attention and vigilance cognitive domain, while controlling for VLS. METHODS:Participants included 205 (median age = 44 years; 77% males; HIV-/METH- n = 67; HIV+/METH - n = 49; HIV-/METH+ n = 36; HIV+/METH+ n = 53) individuals enrolled in the Translational MethamphetamineAIDS Research Center, who completed Conners' and the 5-Choice continuous performance tests (CPTs). RESULTS:METHparticipants exhibited deficits in sustained attention and vigilance; however, these effects were not significant after excluding participants who had a positive urine toxicology screen for methamphetamine. Controlling for VLS, PWH did not have worse sustained attention and vigilance, but consistently displayed slower reaction times across blocks, relative to HIV- participants. There was no HIV x METH interaction on sustained attention and vigilance. CONCLUSIONS: Recent methamphetamine use among METHpeople and detectable viral loads are detrimental to sustained attention and vigilance. These findings highlight the need for prompt diagnosis of HIV and initiation of antiretroviral therapy, and METH use interventions.
Authors: G Chana; I P Everall; L Crews; D Langford; A Adame; I Grant; M Cherner; D Lazzaretto; R Heaton; R Ellis; E Masliah Journal: Neurology Date: 2006-10-24 Impact factor: 9.910
Authors: Jose A Muñoz-Moreno; Carmina R Fumaz; Maria J Ferrer; Anna Prats; Eugènia Negredo; Maite Garolera; Núria Pérez-Alvarez; José Moltó; Guadalupe Gómez; Bonaventura Clotet Journal: AIDS Res Hum Retroviruses Date: 2008-10 Impact factor: 2.205
Authors: Robert K Heaton; Donald R Franklin; Ronald J Ellis; J Allen McCutchan; Scott L Letendre; Shannon Leblanc; Stephanie H Corkran; Nichole A Duarte; David B Clifford; Steven P Woods; Ann C Collier; Christina M Marra; Susan Morgello; Monica Rivera Mindt; Michael J Taylor; Thomas D Marcotte; J Hampton Atkinson; Tanya Wolfson; Benjamin B Gelman; Justin C McArthur; David M Simpson; Ian Abramson; Anthony Gamst; Christine Fennema-Notestine; Terry L Jernigan; Joseph Wong; Igor Grant Journal: J Neurovirol Date: 2010-12-21 Impact factor: 2.643