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Lipid Profiles and APOE4 Allele Impact Midlife Cognitive Decline in HIV-Infected Men on Antiretroviral Therapy

View Article: PubMed Central - PubMed

ABSTRACT

Elevated cholesterol and APOE ε4 genotype were independent risk factors for cognitive decline in antiretroviral therapy–adherent human immunodeficiency virus (HIV)-infected men aged 50–65 years, whereas higher high-density lipoprotein attenuated cognitive decline. Treatment of dyslipidemia may reduce midlife cognitive decline among HIV-infected individuals.

No MeSH data available.


Related in: MedlinePlus

Selection of the human immunodeficiency virus (HIV)–infected and HIV-uninfected study cohort. Subject enrollment and sequential application of inclusion and exclusion criteria to define the study population. *Subjects aged 45–49 years and 50–65 years with neuropsychological scores were counted toward both groups. Heavy drug use was defined as crack, cocaine, or heroin use >50% of visits during study period. Abbreviations: ART, antiretroviral therapy; CNS, central nervous system; HIV+, human immunodeficiency virus infected; HIV−, human immunodeficiency virus uninfected; NP, neuropsychological; OI, opportunistic infection (lymphoma, progressive multifocal leukoencephalopathy, toxoplasmosis, or Cryptococcus); VL, HIV-1 RNA load.
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CIW495F1: Selection of the human immunodeficiency virus (HIV)–infected and HIV-uninfected study cohort. Subject enrollment and sequential application of inclusion and exclusion criteria to define the study population. *Subjects aged 45–49 years and 50–65 years with neuropsychological scores were counted toward both groups. Heavy drug use was defined as crack, cocaine, or heroin use >50% of visits during study period. Abbreviations: ART, antiretroviral therapy; CNS, central nervous system; HIV+, human immunodeficiency virus infected; HIV−, human immunodeficiency virus uninfected; NP, neuropsychological; OI, opportunistic infection (lymphoma, progressive multifocal leukoencephalopathy, toxoplasmosis, or Cryptococcus); VL, HIV-1 RNA load.

Mentions: This study was restricted to MACS visits between January 1996 and December 2010. A sequential process was performed to define the study cohort of 789 men aged 50–65 years (Figure 1; Supplementary Methods). Among 3346 men with visits from 1996 to 2010, 1250 were outside the age for eligibility, had a history of CNS opportunistic infections, or reported cocaine, crack, or heroin use at >50% of visits during the study period, while 653 were excluded due to ART adherence <95% in follow-up and other exclusion criteria (Supplementary Methods). For inclusion, HIV+ participants had to be on ART for ≥1 year prior to baseline visit and have plasma viral load <400 copies/mL at baseline. HIV– controls were matched to HIV+ cases with the MatchIt package in R (version 2.4–21; http://gking.harvard.edu/matchit) [24]. Subjects were matched irrespective of the number of neurocognitive visits to minimize bias that may have been associated with neuropsychological substudy entry; matched covariates included age at study entry, black race, education level, alcohol use, and smoking. Matched subjects with at least 2 neurocognitive visits were included in the final study cohort.Figure 1.


Lipid Profiles and APOE4 Allele Impact Midlife Cognitive Decline in HIV-Infected Men on Antiretroviral Therapy
Selection of the human immunodeficiency virus (HIV)–infected and HIV-uninfected study cohort. Subject enrollment and sequential application of inclusion and exclusion criteria to define the study population. *Subjects aged 45–49 years and 50–65 years with neuropsychological scores were counted toward both groups. Heavy drug use was defined as crack, cocaine, or heroin use >50% of visits during study period. Abbreviations: ART, antiretroviral therapy; CNS, central nervous system; HIV+, human immunodeficiency virus infected; HIV−, human immunodeficiency virus uninfected; NP, neuropsychological; OI, opportunistic infection (lymphoma, progressive multifocal leukoencephalopathy, toxoplasmosis, or Cryptococcus); VL, HIV-1 RNA load.
© Copyright Policy - creative-commons
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5036920&req=5

CIW495F1: Selection of the human immunodeficiency virus (HIV)–infected and HIV-uninfected study cohort. Subject enrollment and sequential application of inclusion and exclusion criteria to define the study population. *Subjects aged 45–49 years and 50–65 years with neuropsychological scores were counted toward both groups. Heavy drug use was defined as crack, cocaine, or heroin use >50% of visits during study period. Abbreviations: ART, antiretroviral therapy; CNS, central nervous system; HIV+, human immunodeficiency virus infected; HIV−, human immunodeficiency virus uninfected; NP, neuropsychological; OI, opportunistic infection (lymphoma, progressive multifocal leukoencephalopathy, toxoplasmosis, or Cryptococcus); VL, HIV-1 RNA load.
Mentions: This study was restricted to MACS visits between January 1996 and December 2010. A sequential process was performed to define the study cohort of 789 men aged 50–65 years (Figure 1; Supplementary Methods). Among 3346 men with visits from 1996 to 2010, 1250 were outside the age for eligibility, had a history of CNS opportunistic infections, or reported cocaine, crack, or heroin use at >50% of visits during the study period, while 653 were excluded due to ART adherence <95% in follow-up and other exclusion criteria (Supplementary Methods). For inclusion, HIV+ participants had to be on ART for ≥1 year prior to baseline visit and have plasma viral load <400 copies/mL at baseline. HIV– controls were matched to HIV+ cases with the MatchIt package in R (version 2.4–21; http://gking.harvard.edu/matchit) [24]. Subjects were matched irrespective of the number of neurocognitive visits to minimize bias that may have been associated with neuropsychological substudy entry; matched covariates included age at study entry, black race, education level, alcohol use, and smoking. Matched subjects with at least 2 neurocognitive visits were included in the final study cohort.Figure 1.

View Article: PubMed Central - PubMed

ABSTRACT

Elevated cholesterol and APOE &epsilon;4 genotype were independent risk factors for cognitive decline in antiretroviral therapy&ndash;adherent human immunodeficiency virus (HIV)-infected men aged 50&ndash;65 years, whereas higher high-density lipoprotein attenuated cognitive decline. Treatment of dyslipidemia may reduce midlife cognitive decline among HIV-infected individuals.

No MeSH data available.


Related in: MedlinePlus