HIV, Depression, and Cognitive Impairment in the Era of Effective Antiretroviral Therapy

Rubin, Leah H.; Maki, Pauline M.

doi:10.1007/s11904-019-00421-0

Cited by 140 publications

(102 citation statements)

References 105 publications

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“…Not surprisingly, HIV-1 infection is associated with greater risk of psychiatric illness, and this can exacerbate and complicate cognitive impairment (Rubin et al 2019;Rubin and Maki 2019;Spies et al 2018;Cysique and Brew 2019). Depression can result from the personal and psychosocial impacts of the disease, as well as biological effects of infection and treatment (Lu et al 2019).…”

Section: Sars-cov-2 and Hiv-1: Differences In Virology And Host Immunmentioning

confidence: 99%

Studying the neuropsychological sequelae of SARS-CoV-2: lessons learned from 35 years of neuroHIV research

2020

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The virology of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and the human immune response to the virus are under vigorous investigation. There are now several reports describing neurological symptoms in individuals who develop coronavirus disease 2019 (COVID-19), the syndrome associated with SARS-CoV-2 infection. The prevalence, incidence, and clinical course of these symptoms will become clearer in the coming months and years through epidemiological studies. However, the long-term neurological and cognitive consequence of SARS-CoV-2 infection will remain conjectural for some time and will likely require the creation of cohort studies that include uninfected individuals. Considering the early evidence for neurological involvement in COVID-19 it may prove helpful to compare SARS-CoV-2 with another endemic and neurovirulent virus, human immunodeficiency virus-1 (HIV-1), when designing such cohort studies and when making predictions about neuropsychological outcomes. In this paper, similarities and differences between SARS-CoV-2 and HIV-1 are reviewed, including routes of neuroinvasion, putative mechanisms of neurovirulence, and factors involved in possible long-term neuropsychological sequelae. Application of the knowledge gained from over three decades of neuroHIV research is discussed, with a focus on alerting researchers and clinicians to the challenges in determining the cause of neurocognitive deficits among long-term survivors. Keywords Neuropsychology. COVID-19. SARS-CoV-2. NeuroHIV. HIV-associated neurocognitive disorders COVID-19: neurological symptoms and outcomes Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the associated syndrome, coronavirus disease 2019 (COVID-19), first gained attention in December of 2019 in the city of Wuhan, China (World Health Organization: Naming the coronavirus disease (COVID-19) and the virus that causes it 2020). Transmission to humans was zoonotic, apparently originating in bats (Zhou et al.

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Section: Sars-cov-2 and Hiv-1: Differences In Virology And Host Immunmentioning

confidence: 99%

Studying the neuropsychological sequelae of SARS-CoV-2: lessons learned from 35 years of neuroHIV research

2020

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“…Depression is the most common neuropsychiatric condition in PLWH with a prevalence rate three times that of the general population. 49 The confounding effect of depression in HAND arises from similar neuropathology which involves the loss of adult neurogenesis in the hippocampus. 50 HIVinfected individuals however may experience depression despite elevated BDNF levels.…”

Section: Bdnf and Co-morbid Mental Health Disorders In Handmentioning

confidence: 99%

<p>The Role of Brain Derived Neurotrophic Factor in HIV-Associated Neurocognitive Disorder: From the Bench-Top to the Bedside</p>

Michael

Mpofana

Ramlall

et al. 2020

NDT

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Human immunodeficiency virus (HIV)-associated neurocognitive disorder (HAND) remains prevalent in the anti-retroviral (ART) era. While there is a complex interplay of many factors in the neuropathogenesis of HAND, decreased neurotrophic synthesis has been shown to contribute to synaptic degeneration which is a hallmark of HAND neuropathology. Brain derived neurotrophic factor (BDNF) is the most abundant and synaptic-promoting neurotrophic factor in the brain and plays a critical role in both learning and memory. Reduced BDNF levels can worsen neurocognitive impairment in HIV-positive individuals across several domains. In this paper, we review the evidence from pre-clinical and clinical studies showing the neuroprotective roles of BDNF against viral proteins, effect on co-morbid mental health disorders, altered human microbiome and ART in HAND management. Potential applications of BDNF modulation in pharmacotherapeutic, cognitive and behavioral interventions in HAND are also discussed. Finally, research gaps and future research direction are identified with the aim of helping researchers to direct efforts to make these BDNF driven interventions improve the quality of life of patients living with HAND.

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“…Here, we leveraged a rich longitudinal dataset including large groups of both virally suppressed and non-virally suppressed women to examine longitudinal phenotyping of declarative memory, a domain commonly impaired, among HIV+ compared to HIV− women (Maki et al, 2015;Rubin and Maki, 2019). We advanced our previous findings in women with HIV by disentangling the heterogeneity in declarative memory over age-time among HIV+ and HIV− women (Rubin et al, 2017b) using a data driven modeling approach.…”

Section: Discussionmentioning

confidence: 99%

“…One potential key to advancing our understanding of NCI among PWH is to acknowledge and account for the considerable heterogeneity in the degree and pattern of NCI within PWH. There is mounting evidence that NCI in PWH is better characterized by heterogeneity in the degree and pattern of NCI than by homogeneity (Brouillette et al, 2016;Rubin and Maki, 2019). Heterogeneity in cross-sectional neuropsychological profiles and longitudinal neurocognitive trajectories in PWH suggests that NCI may be comprised of multiple neurocognitive conditions with potentially mixed etiologies and/or different predictors (e.g., a different underlying clinical or genetic risk profile, for example) that may have different implications for the treatment of NCI in PWH (Brouillette et al, 2016;Gomez et al, 2019;Rubin and Maki, 2019).…”

Section: Introductionmentioning

confidence: 99%

Factors Predicting Detrimental Change in Declarative Memory Among Women With HIV: A Study of Heterogeneity in Cognition

Fitzgerald

Maki

et al. 2020

Front. Psychol.

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Objective: Statistical techniques used to study cognitive function in HIV typically yield normative estimates and can mask the heterogeneity in cognitive trajectories over time. We applied a novel statistical approach to identify clusters of individuals with distinct patterns of change in declarative memory in HIV-seropositive (HIV+) and HIV-seronegative (HIV−) women. Methods: 1731 women from the Women's Interagency HIV Study, a multi-center, prospective cohort study, completed the Hopkins Verbal Learning Test-Revised (HLVT-R) at >2 visits. To derive subgroups with similar patterns of decline by HIV-serostatus, we used a mixed-effects framework that modeled the trajectory of multiple declarative memory outcomes over time, while simultaneously clustering individuals. Results: Of the 1731 participants, 1149 were HIV+ (70% Black/African American [AA]; 30% White/Other [W/O]) and 582 were HIV− (68% AA; 32% W/O). Race stratification was necessary to optimize clustering. Among HIV+AA's, four subgroups emerged: a subgroup with minimal decline, two with accelerated decline, and one with stable but low performance. In HIV− AA, three subgroups emerged: one with minimal decline and two with accelerated decline. In multivariable-adjusted models among HIV+, individuals with accelerated decline were less educated (P < 0.001) and more likely to have a history of depression (P < 0.001) versus those with minimal decline. Similar subgroups were identified in W/O HIV+ and W/O HIV− participants.

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HIV, Depression, and Cognitive Impairment in the Era of Effective Antiretroviral Therapy

Cited by 140 publications

References 105 publications

Studying the neuropsychological sequelae of SARS-CoV-2: lessons learned from 35 years of neuroHIV research

Studying the neuropsychological sequelae of SARS-CoV-2: lessons learned from 35 years of neuroHIV research

<p>The Role of Brain Derived Neurotrophic Factor in HIV-Associated Neurocognitive Disorder: From the Bench-Top to the Bedside</p>

Factors Predicting Detrimental Change in Declarative Memory Among Women With HIV: A Study of Heterogeneity in Cognition

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