HIV-associated neurocognitive disorders persist in the era of potent  antiretroviral therapy

Heaton, Robert K.; Clifford, David B.; Franklin, Donald; Woods, Steven Paul; Ake, Christopher F.; Vaida, Florin; Ellis, Ronald J.; Letendre, Scott; Marcotte, Thomas D.; Atkinson, J. Hampton; Mindt, Monica Rivera; Vigil, Ofilio; Taylor, Michael J.; Collier, Ann C.; Marra, Christina M.; Gelman, Benjamin B.; McArthur, Justin C.; Morgello, Susan; Simpson, David M.; McCutchan, J. Allen; Abramson, Ian; Gamst, Anthony; Fennema-Notestine, Christine; Jernigan, Terry L.; Wong, Jillian W.; Grant, Igor

doi:10.1212/wnl.0b013e318200d727

Cited by 2,124 publications

(2,299 citation statements)

References 31 publications

Supporting

Mentioning

2,143

Contrasting

Unclassified

Order By: Relevance

“…Dada la proporción de personas con VIH que demuestran problemas neurocognitivos relacionados con esta enfermedad, será importante enfocar los esfuerzos Introduction Antiretroviral therapy (ART) has improved a number of health outcomes and extended the lifespan of individuals infected with human immunodeficiency virus [1,2]. Yet, HIV-associated neurocognitive impairment (NCI) continues to be prevalent, with approximately half of communitydwelling HIV-infected adults experiencing NCI [3]. Although the most severe form of HIV-associated neurocognitive disorders (HAND), HIV-associated dementia (HAD), is on the decline, there is evidence that the milder forms of HAND have increased in prevalence [3].…”

mentioning

confidence: 99%

“…Yet, HIV-associated neurocognitive impairment (NCI) continues to be prevalent, with approximately half of communitydwelling HIV-infected adults experiencing NCI [3]. Although the most severe form of HIV-associated neurocognitive disorders (HAND), HIV-associated dementia (HAD), is on the decline, there is evidence that the milder forms of HAND have increased in prevalence [3]. Even mild NCI can lead to problems with everyday functioning, including medication adherence, driving, and financial management [4][5][6][7].…”

mentioning

confidence: 99%

See 1 more Smart Citation

A Longitudinal Analysis of the Impact of Physical Activity on Neurocognitive Functioning Among HIV-Infected Adults

et al. 2016

View full text Add to dashboard Cite

Higher levels of physical activity (PA) have been linked to better neurocognitive functioning in many populations. The current study examines the longitudinal association between PA and neurocognitive functioning among HIV-infected and HIV-uninfected persons. Community-dwelling adults (N = 291) self-reported level of PA and completed a comprehensive neuropsychological battery at two to four study visits (Mean follow-up time = 2.6 years). Participants were divided into three PA groups: ''No PA'' (no PA at any visit), ''consistent PA'' (PA at C50% of visits), and ''inconsistent PA'' (PA \ 50% of visits). A mixed effect model, adjusting for significant covariates showed that all PA groups had statistically significant, yet modest, neurocognitive decline over time; and, the consistent PA group began with, and maintained, significantly better neurocognitive function compared to the other two PA groups. This effect was evident among both HIV-uninfected and HIV-infected persons, despite the fact that HIV-infected persons showed lower baseline neurocognitive function. PA is a modifiable lifestyle behavior that may help to protect against neurocognitive impairment regardless of HIV status, however, given the proportion of HIV-infected individuals who evidence neurocognitive difficulties, a focus on increasing PA seems warranted.Resumen La actividad física (AF) ha sido asociada con un mejor funcionamiento neurocognitivo en varios grupos. Este estudio examinó la asociación longitudinal entre la AF y el funcionamiento neurocognitivo en personas con y sin infección del VIH. Adultos viviendo en la comunidad (N = 291) proporcionaron información acerca de sus niveles de AF y completaron una batería neuropsicológica exhaustiva. Los participantes completaron entre dos y cuatro visitas relacionadas con el estudio (tiempo de seguimiento promedio = 2,6 años) y fueron divididos en tres grupos de AF: ''Ninguna AF'' (Ninguna AF durante todas las visitas del estudio), ''AF Consistente'' (AF durante 50% o más de las visitas del estudio), y ''AF Inconsistente'' (AF durante menos del 50% de las visitas del estudio). Un modelo estadístico mixto, ajustando por el efecto de variables externas, indicó que hubo una reducción estadísticamente significativa, pero poco pronunciada, en el funcionamiento neurocognitivo en todos los grupos. Además, el grupo con AF Consistente demostró un mejor funcionamiento neurocognitivo en comparación con los otros dos grupos de AF al comienzo del estudio, el cual se mantuvo durante el seguimiento. A pesar de que las personas con VIH demostraron un funcionamiento neurocognitivo más bajo al comienzo del estudio que las personas sin VIH, el efecto de AF fue demostrado en los dos grupos. Es importante recalcar que la AF es un factor de vida modificable que podría proteger contra los daños neurocognitivos independientemente de si las personas tienen o no VIH. Dada la proporción de personas con VIH que demuestran problemas neurocognitivos relacionados con esta enfermedad, será importante enfocar los esfuerzos ...

show abstract

mentioning

confidence: 99%

mentioning

confidence: 99%

A Longitudinal Analysis of the Impact of Physical Activity on Neurocognitive Functioning Among HIV-Infected Adults

et al. 2016

View full text Add to dashboard Cite

show abstract

“…Not all neurocognitive impairment in a patient with HIV is caused by HIV, and cART will not benefit impairment that is pre-existing or due to comorbid conditions. In one large multicenter study, more than a third of impaired individuals had confounding comorbidities other than HIV judged of sufficient cumulative severity to explain their cognitive impairment [25].…”

Section: Combination Art and Treatment Of Hiv-associated Neurocognitimentioning

confidence: 99%

Update and New Directions in Therapeutics for Neurological Complications of HIV Infections

Ellis

Letendre

2016

Neurotherapeutics

View full text Add to dashboard Cite

show abstract

“…Although combination antiretroviral therapy (ART) is associated with improvements in neurocognition among persons living with HIV, many suffer from a spectrum of neuropsychological (NP) impairments known collectively as HIV‐associated neurocognitive disorders (HAND) despite ART (Antinori et al., 2007; Heaton, Clifford, Franklin, Woods, & Ake, 2010; Heaton, Franklin, Ellis, McCutchan, & Lentendre, 2011). HAND can manifest as difficulty with executive functioning, information processing speed, motor deficits, and/or memory deficits (Smith et al., 2014).…”

Section: Introductionmentioning

confidence: 99%

Similar changes in neuropsychological functioning in english and spanish speaking HIV patients

et al. 2018

View full text Add to dashboard Cite

ObjectivePrimary language has been reported to influence the results of neuropsychological (NP) testing. We sought to determine whether being a primary Spanish versus English speaker affects changes in neuropsychological evaluations in persons living with HIV.MethodData from 209 (188 English speakers and 21 Spanish speakers) ART‐naïve HIV‐infected adults were extracted from ACTG A5303, a 48‐week randomized clinical trial of two HIV treatment regimens. Participants’ mean (standard deviation) age and years of education were 35.1 (10.7) and 14.3 (2.7) years respectively. Changes from baseline to week 48 of antiretroviral therapy (ART) in individual, total, and domain z‐scores for NP tests and Global Deficit Scores (GDS) were compared between the primary languages using linear regression models, adjusted for baseline scores and years of education.ResultsBaseline demographic characteristics were comparable except Spanish speakers had less years of education than the English speakers (p < 0.001). Although differences in some NP measures and domains were detected at baseline, the adjusted changes in individual, total and domain NP z‐scores from baseline to 48 weeks of ART were not significantly different between the two primary language groups. The 48‐week changes in GDS were also similar.ConclusionChanges in NP during ART were similar between English and Spanish speaking HIV‐infected individuals for all NP measures. This suggests that studies of longitudinal changes in NP can pool participants across these languages.

show abstract

HIV-associated neurocognitive disorders persist in the era of potent antiretroviral therapy

Cited by 2,124 publications

References 31 publications

A Longitudinal Analysis of the Impact of Physical Activity on Neurocognitive Functioning Among HIV-Infected Adults

A Longitudinal Analysis of the Impact of Physical Activity on Neurocognitive Functioning Among HIV-Infected Adults

Update and New Directions in Therapeutics for Neurological Complications of HIV Infections

Similar changes in neuropsychological functioning in english and spanish speaking HIV patients

Contact Info

Product

Resources

About