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Interaction Effects between HIV and Aging on Selective Neurocognitive Impairment

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Abstract

HIV infection and aging are each associated with neurocognitive impairment (NCI). This study examined the combined effects of HIV infection and aging on NCI. We performed a cross-sectional survey among 345 HIV-infected and 345 HIV-uninfected participants aged at least 40 years. The International HIV Dementia Scale (IHDS) and Chinese version of Mini-mental State Examination (MMSE) were administered to screen for NCI. HIV-infected individuals had higher prevalence of NCI than uninfected individuals (46.7% vs 15.1% for IHDS using cut-off of ≤ 10; 17.1% vs 2.6% for MMSE). Significant main effects of HIV and age were observed on IHDS and MMSE composite scores and all domains except for HIV on attention and calculation. Significant interaction effects between HIV and age were observed on motor speed, orientation, registration and recall, and mainly attributed to the inferior performance of HIV-infected patients aged over 60 years. Among HIV-infected individuals, in multivariable logistic models, older age, depressive symptoms and history of nevirapine treatment were associated with NCI using both IHDS and MMSE, whereas lower education current smoker and current CD4 ≥ 800 cells/μL were associated only with NCI using IHDS, and hypertension was associated only with NCI using MMSE. Findings suggest that HIV and older age may confer interactive effects on cognitive function in several domains with older HIV-infected adults experiencing greater NCI, which requires further longitudinal investigation. Furthermore, HIV early diagnosis and treatment may prevent or reverse NCI, but extra attention should be given to adverse effects including metabolic changes associated with long-term treatment.

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Acknowledgements

The authors wish to thank all study participants for taking part in the study. This study was supported by the Shanghai Municipal Health and Family Planning Commission (GWTD2015S05, 15GWZK0101), the Natural Science Foundation of China (grant number 81373062, 81402725), and the Junior Faculty Award of Fudan University (grant number JJF201016).

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  1. Yingying Ding and Haijiang Lin contributed equally to this work.

Authors and Affiliations

  1. Department of Epidemiology, School of Public Health, Fudan University, Shanghai, 200032, China

    Yingying Ding, Haijiang Lin, Meiyang Gao & Na He

  2. The Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, 200032, China

    Yingying Ding, Meiyang Gao & Na He

  3. Taizhou City Center for Disease Control and Prevention, Taizhou City, Zhejiang Province, China

    Haijiang Lin, Weiwei Shen & Qionghai Wu

  4. Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai, China

    Na He

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  1. Yingying Ding
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  2. Haijiang Lin
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Contributions

Y. D. and N. H. conceived and designed the study. Y. D. and H. L. supervised the participant recruitment and data collection. M. G., W. S., and Q.W. recruited the participants and collected data. Y. D. analyzed the data and wrote the first draft of the manuscript. All authors contributed to data interpretation and writing of the manuscript.

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Correspondence to Na He.

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Ding, Y., Lin, H., Shen, W. et al. Interaction Effects between HIV and Aging on Selective Neurocognitive Impairment. J Neuroimmune Pharmacol 12, 661–669 (2017). https://doi.org/10.1007/s11481-017-9748-3

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