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Sex differences in neurocognitive screening among adults living with HIV in China

  • Xiaotong Qiao
  • Haijiang Lin
  • Xiaoxiao Chen
  • Chenxi Ning
  • Keran Wang
  • Weiwei Shen
  • Xiaohui Xu
  • Xiaoyi Xu
  • Xing Liu
  • Na He
  • Yingying DingEmail author
Article

Abstract

HIV-infected (HIV+) women may be more vulnerable to neurocognitive impairment (NCI) due to psychological and physiological factors but previous studies show mixed findings. We investigated the neurocognitive performances in HIV+ versus HIV− women and men. This cross-sectional analysis included 669 HIV+ patients (223 women) and 1338 HIV-uninfected (HIV−) controls (446 women) which were frequency matched on sex, education, and 5-year age categories. NCI was screened using the Mini-mental State Examination. Psychomotor speed was assessed using timed alternating hand sequence test. Prevalence of NCI was higher among women versus men in the HIV+ group (16.1% vs 10.5%) but not the HIV− group (4.3% vs 3.5%). HIV+ women performed worse compared to men on psychomotor speed, orientation, attention, and calculation, whereas HIV− women performed worse compared to men on attention and calculation. Adjusted interaction effects of HIV status × sex (women vs men) were significant on orientation, attention, and calculation, and marginally significant on psychomotor speed (p = 0.053). In multivariable models, among both HIV+ women and men, less years of education and depressive symptoms were associated with NCI. Waist-to-hip ratio above the cut-off was strongly associated with NCI among HIV+ women. HIV+ women perform worse on cognitive measures compared to HIV+ men. The association of central obesity with NCI in HIV+ women should be noted.

Keywords

HIV Sex difference Neurocognitive impairment China 

Notes

Funding

This study was funded by the China National Science and Technology Major Projects on Infectious Diseases (grant number 2018ZX10721102-004) and the National Natural Science Foundation of China (grant numbers 81872671, 81803291) and partially supported by the Shanghai Municipal Health and Family Planning Commission (grant numbers GWTD2015S05, 15GWZK0101).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

13365_2019_727_MOESM1_ESM.doc (56 kb)
ESM 1 (DOC 56 kb)

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Copyright information

© Journal of NeuroVirology, Inc. 2019

Authors and Affiliations

  • Xiaotong Qiao
    • 1
  • Haijiang Lin
    • 2
  • Xiaoxiao Chen
    • 2
  • Chenxi Ning
    • 1
  • Keran Wang
    • 1
  • Weiwei Shen
    • 2
  • Xiaohui Xu
    • 1
  • Xiaoyi Xu
    • 1
  • Xing Liu
    • 1
    • 3
  • Na He
    • 1
    • 3
  • Yingying Ding
    • 1
    • 3
    Email author
  1. 1.Department of Epidemiology, School of Public Health, The Key Laboratory of Public Health Safety of Ministry of EducationFudan UniversityShanghaiChina
  2. 2.Taizhou City Center for Disease Control and PreventionTaizhou CityChina
  3. 3.Collaborative Innovation Center of Social Risks Governance in HealthFudan UniversityShanghaiChina

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