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Journal of NeuroVirology

, Volume 23, Issue 4, pp 550–557 | Cite as

The nature and consequences of cognitive deficits among tobacco smokers with HIV: a comparison to tobacco smokers without HIV

  • Joseph D. Harrison
  • Jessica A. Dochney
  • Sonja Blazekovic
  • Frank Leone
  • David Metzger
  • Ian Frank
  • Robert Gross
  • Anita Hole
  • Karam Mounzer
  • Steven Siegel
  • Robert A. Schnoll
  • Rebecca L. Ashare
Article

Abstract

HIV-infected smokers lose more years of life to tobacco-related disease than HIV. Since neurocognitive deficits are common among those with HIV and are associated with smoking persistence, these deficits may be a unique barrier to smoking cessation among HIV-infected smokers. Documenting unique differences in and correlates of cognition among HIV-infected smokers is a critical step towards developing a population-specific tobacco cessation treatment. We compared neurocognitive function between HIV-infected (n = 103) and HIV-uninfected smokers (n = 70), accounting for demographic and smoking-related variables. We also evaluated whether HIV-related health outcomes (e.g., CD4 count, viral load, depression ratings, quality of life [QoL]) and HAART adherence were associated with cognition. Participants completed neurocognitive tasks (N-back and Continuous Performance Task [CPT]) measuring working memory, attention, and processing speed, and intra-individual variability. Stepwise regression models were conducted and validated with resampling techniques. HIV-infected smokers performed worse than HIV-uninfected smokers on working memory, processing speed, and intra-individual variability (all p < 0.01). ROC analysis for the model including cognitive measures demonstrated 85% area under the curve, which indicates “good prediction” for distinguishing between HIV-infected and HIV-uninfected smokers. This was a significant improvement over the model including demographic and smoking-related variables only (p = 0.0003). Among HIV-infected smokers, neurocognitive performance was negatively associated with QoL and depression ratings. Smoking cessation interventions for HIV-infected smokers should consider cognitive neurorehabilitation as a potential strategy to decrease the likelihood of nicotine relapse and decrease tobacco-related morbidity in this population.

Keywords

Smoking cessation HIV Cognition HIV-associated neurocognitive disorder Tobacco use 

Notes

Acknowledgements

This research was supported by grants from the National Institute on Drug Abuse (R01 DA033681 and K23 DA035295) and through core services and support from the Penn Center for AIDS Research (P30 AI045008) and Penn Mental Health AIDS Research Center (P30 MH097488).

Compliance with ethical standards

Conflict of interest

Dr. Schnoll receives medication and placebo free from Pfizer and has provided consultation to Pfizer and GlaxoSmithKline. These companies had no involvement in this study.

Dr. Siegel has received grants and/or has acted as a consultant to Astellas, Merck, and Zynerba that is unrelated to the content of this manuscript.

Dr. Gross sits on a Data Safety and Management Board for a Pfizer drug treating inflammatory bowel disease that is unrelated to the contents of this manuscript.

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Copyright information

© Journal of NeuroVirology, Inc. 2017

Authors and Affiliations

  • Joseph D. Harrison
    • 1
  • Jessica A. Dochney
    • 1
  • Sonja Blazekovic
    • 1
  • Frank Leone
    • 2
  • David Metzger
    • 1
  • Ian Frank
    • 3
  • Robert Gross
    • 3
    • 4
  • Anita Hole
    • 1
  • Karam Mounzer
    • 5
  • Steven Siegel
    • 6
  • Robert A. Schnoll
    • 7
  • Rebecca L. Ashare
    • 1
  1. 1.Department of PsychiatryUniversity of Pennsylvania Perelman School of MedicinePhiladelphiaUSA
  2. 2.Pulmonary, Allergy, & Critical Care DivisionUniversity of Pennsylvania Presbyterian Medical CenterPhiladelphiaUSA
  3. 3.Division of Infectious DiseasesUniversity of Pennsylvania Perelman School of MedicinePhiladelphiaUSA
  4. 4.Center for Clinical Epidemiology and BiostatisticsUniversity of PennsylvaniaPhiladelphiaUSA
  5. 5.Philadelphia FightPhiladelphiaUSA
  6. 6.Department of Psychiatry and Behavioral SciencesKeck School of Medicine of the University of Southern CaliforniaLos AngelesUSA
  7. 7.Department of Psychiatry and Abramson Cancer CenterUniversity of PennsylvaniaPennsylvaniUSA

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