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Sex differences in cognitive function among people with HIV-1 clade C infection in Northern India

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Abstract

Human immunodeficiency virus-1 (HIV-1) clade C is the most prevalent form of HIV-1 comprising nearly 46% of global infections and is the dominant subtype in India. Despite its predominance, the impact of HIV-1 clade C infection on cognitive function has been understudied in comparison with other subtypes, notably clade B, which is primarily found in Europe and North America. Few studies have assessed cognitive impairment in antiretroviral therapy (ART) naïve men and women with HIV-1 clade C infection. In this study conducted in Northern India, differences in neuropsychological functioning were compared between 109 participants (70 men, 39 women) with untreated HIV-1 clade C infection and 110 demographically matched healthy controls (74 men, 36 women). A comprehensive neuropsychological battery was used to examine depression, self-assessment of functioning, and cognitive performance in six domains of functioning. Group differences were assessed by HIV-1 status and sex, controlling for age and education. Results indicated that cognitive deficits were substantially greater among male participants with HIV-1 clade C compared to male controls in all domains of cognitive functioning; in contrast, women with HIV-1 clade C had only minor deficits compared to healthy female participants. In addition, a larger proportion of men with HIV-1 clade C exhibited high levels of depression than women with HIV-1 clade C. These findings suggest that untreated HIV-1 clade C infection in men can have debilitating effects on neuropsychological function and depression, and stress the importance of facilitating rapid access to treatment to reduce the impact of HIV-1 infection.

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Data availability

The data that support the findings of this study are available from the authors upon reasonable request.

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Funding

This study was funded by the National Institute of Neurological Disorders and Stroke, part of the US National Institutes of Health, grant number R01NS094043.

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Authors and Affiliations

  1. Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education & Research, Chandigarh, Punjab, India

    Anchal Sharma, Deepika Aggarwal, Sameer Vyas & Paramjeet Singh

  2. Department of Neurosurgery, Postgraduate Institute of Medical Education & Research, Chandigarh, Punjab, India

    Manju Mohanty

  3. Department of Radiology, University of Miami Miller School of Medicine, Miami, FL, USA

    Teddy Salan & Varan Govind

  4. Department of Psychiatry, University of Miami Miller School of Medicine, Miami, FL, USA

    Lissa Mandell, Deborah L. Jones & Mahendra Kumar

  5. Department of Public Health, University of Miami Miller School of Medicine, Miami, FL, USA

    Kristopher Arheart

  6. Clinical Immunology and Rheumatology Services, Department of Internal Medicine, Postgraduate Institute of Medical Education & Research, Chandigarh, Punjab, India

    Aman Sharma

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  1. Anchal Sharma
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Correspondence to Varan Govind.

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Sharma, A., Mohanty, M., Salan, T. et al. Sex differences in cognitive function among people with HIV-1 clade C infection in Northern India. J. Neurovirol. 29, 614–625 (2023). https://doi.org/10.1007/s13365-023-01166-8

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