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. 2019 Feb;25(1):9-21.
doi: 10.1007/s13365-018-0679-4. Epub 2018 Oct 8.

Effects of age, HIV, and HIV-associated clinical factors on neuropsychological functioning and brain regional volume in HIV+ patients on effective treatment

Natalia Gawron  1 , M Choiński  2   3 , B Szymańska-Kotwica  4 , A Pluta  2   5 , M Sobańska  2 , A R Egbert  2   6 , A Desowska  2 , T Wolak  5 , A Horban  4 , E Firląg-Burkacka  4 , P Bieńkowski  7 , H Sienkiewicz-Jarosz  8 , A Scińska-Bieńkowska  9 , B Biswal  6 , S M Rao  10 , R Bornstein  11 , E Łojek  2
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Free PMC article

Effects of age, HIV, and HIV-associated clinical factors on neuropsychological functioning and brain regional volume in HIV+ patients on effective treatment

Natalia Gawron et al. J Neurovirol. 2019 Feb.
Free PMC article

Abstract

It is yet unclear if people infected with human immunodeficiency virus (HIV+) on stable, combined antiretroviral therapies (cARTs) decline with age at the same or greater rate than healthy people. In this study, we examined independent and interactive effects of HIV, age, and HIV-related clinical parameters on neuropsychological functioning and brain regional volume in a sizable group of Polish HIV+ men receiving cART. We also estimated the impact of nadir CD4 cell count, CD4 cell count during participation in the study, duration of HIV infection, or duration of cART along with age. Ninety-one HIV+ and 95 control (HIV-) volunteers ages 23-75 completed a battery of neuropsychological tests, and 54 HIV+ and 62 HIV- of these volunteers participated in a brain imaging assessment. Regional brain volume in the cortical and subcortical regions was measured using voxel-based morphometry. We have found that HIV and older age were independently related to lower attention, working memory, nonverbal fluency, and visuomotor dexterity. Older age but not HIV was associated with less volume in several cortical and subcortical brain regions. In the oldest HIV+ participants, age had a moderating effect on the relationship between the duration of cART and visuomotor performance, such as that older age decreased speed of visuomotor performance along with every year on cART. Such results may reflect the efficacy of cART in preventing HIV-associated brain damage. They also highlight the importance of monitoring neuropsychological functioning and brain structure in HIV+ patients. This is particularly important in older patients with long adherence to cART.

Keywords: Aging; Brain volume; CD4 cell count nadir; HIV; Neuropsychological functioning; cART.

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Conflict of interest statement

The study was carried out according to the Code of Ethics of the World Medical Association (Declaration of Helsinki).

Figures

Plot 1
Plot 1
The moderating effect of age on the relationship between the duration of cART and the time to place pegs with non-preferred hand in Grooved Pegboard Test in groups of HIV+ participants of mean age 29.3 years (younger), 41.2 (average), 53.1 (older). Variables are mean centered
Plot 2
Plot 2
Significance region of the moderating effect of age on the relationship between the duration of cART and the time to place pegs with non-dominant hand in Grooved Pegboard Test based on Johnson-Neyman output. Variables are mean centered. Significance region is situated for age > 12.1 years from the mean, p < .0016, i.e., > 53.4 years
Plot 3
Plot 3
The moderating effect of age on the relationship between the duration of cART and the time to remove pegs with non-dominant hand in Grooved Pegboard Test in groups of HIV+ participants of mean age 29.3 years (younger), 41.2 (average), 53.1 (older). Variables are mean centered
Plot 4
Plot 4
Significance region of the moderating effect of age on the relationship between the duration of cART and the time to remove the pegs with non-dominant hand in Grooved Pegboard Test based on Johnson-Neyman output. Variables are mean centered. Significance region is situated for age > 17. 9 years from the mean, p = .002, i.e., > 59.1 years
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