Journal of NeuroVirology

, 17:469

Associations of cardiovascular variables and HAART with cognition in middle-aged HIV-infected and uninfected women

  • Howard A. Crystal
  • Jeremy Weedon
  • Susan Holman
  • Jennifer Manly
  • Victor Valcour
  • Mardge Cohen
  • Kathryn Anastos
  • Chenglong Liu
  • Wendy J. Mack
  • Elizabeth Golub
  • Jason Lazar
  • Ann Ho
  • Mary Jeanne Kreek
  • Robert C. Kaplan
Article

DOI: 10.1007/s13365-011-0052-3

Cite this article as:
Crystal, H.A., Weedon, J., Holman, S. et al. J. Neurovirol. (2011) 17: 469. doi:10.1007/s13365-011-0052-3

Abstract

Despite the use of highly active anti-retroviral treatment (HAART), cognitive impairment remains prevalent in HIV. Indeed a recent study suggested that in certain instances, stopping HAART was associated with improved cognitive function (Robertson et al. Neurology 74(16):1260–1266 2010). HAART is occasionally associated with cardiovascular pathology and such pathology may be associated with cognitive impairment. To explore these associations, we assessed the relative contributions of cardiovascular variables such as hypertension and atherosclerosis, of HIV and HAART to cognition. The participants were members of the Women’s Interagency HIV Study. In the analysis of cross-sectional data using general linear models, we assessed the relationship between each cardiovascular variable and Stroop interference time and symbol digit modalities test while adjusting for age, HIV, education, depression, and race/ethnicity. We also analyzed the association of summary measures of HAART use with cognition. In multivariate models, significance was limited to carotid lesions and carotid intima–medial thickness quintile (CIMT) with Stroop interference time (for carotid lesions, coefficient = 10.5, CI 3.5 to 17.5, p = 0.003, N = 1,130; for CIMT quintile, coefficient = 8.6, CI = 1.7 to 15.4, p = 0.025, N = 1,130). The summary measures of protease inhibitor use and other HAART measures were in most cases not associated with cognitive score in multivariate models. We conclude that in the HAART era among middle-aged women with HIV, carotid disease may be significantly associated with some measures of cognitive impairment. In this cross-sectional study, we could detect neither positive nor negative effects of HAART on cognition.

Keywords

Cognition HIV Women Hypertension Atherosclerosis Middle-aged 

Copyright information

© Journal of NeuroVirology, Inc. 2011

Authors and Affiliations

  • Howard A. Crystal
    • 1
    • 1
  • Jeremy Weedon
    • 3
  • Susan Holman
    • 2
  • Jennifer Manly
    • 5
  • Victor Valcour
    • 6
    • 13
  • Mardge Cohen
    • 7
  • Kathryn Anastos
    • 8
  • Chenglong Liu
    • 10
  • Wendy J. Mack
    • 11
  • Elizabeth Golub
    • 12
  • Jason Lazar
    • 2
  • Ann Ho
    • 4
  • Mary Jeanne Kreek
    • 4
  • Robert C. Kaplan
    • 9
  1. 1.Department of NeurologySUNY Downstate Medical CenterBrooklynUSA
  2. 2.Department of MedicineSUNY Downstate Medical CenterBrooklynUSA
  3. 3.Department of Scientific Computing CenterSUNY Downstate Medical CenterBrooklynUSA
  4. 4.Laboratory of the Biology of Addictive DiseasesThe Rockefeller UniversityNew YorkUSA
  5. 5.Department of NeurologyColumbia University Medical CenterNew YorkUSA
  6. 6.Memory and Aging Center, Department of NeurologyUniversity of CaliforniaSan FranciscoUSA
  7. 7.The CORE Center at John H. Stroger Hospital of Cook CountyChicagoUSA
  8. 8.Department of MedicineMontefiore Medical CenterBronxUSA
  9. 9.Department of Epidemiology and Population HealthAlbert Einstein College of MedicineBronxUSA
  10. 10.Department of MedicineGeorgetown University School of MedicineWashingtonUSA
  11. 11.Department of Preventive Medicine, Keck School of MedicineUniversity of Southern CaliforniaLos AngelesUSA
  12. 12.Department of EpidemiologyJohns Hopkins Bloomberg School of Public HealthBaltimoreUSA
  13. 13.Division of Geriatric Medicine, Department of MedicineUniversity of CaliforniaSan FranciscoUSA

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