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Association of HIV serostatus and metabolic syndrome with neurobehavioral disturbances

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Abstract

Metabolic syndrome (MetS), a constellation of related metabolic risk factors, is a common comorbidity associated with cognitive difficulty in people living with HIV (PLWH). Neurobehavioral disturbances (e.g., behavioral manifestations of frontal-subcortical dysfunction) are also prevalent in HIV, yet the role MetS might play in HIV-associated neurobehavioral disturbances is unknown. Thus, we examined the link between MetS and neurobehavioral disturbances in PLWH. Participants included 215 adults (117 PLWH, 98 HIV-uninfected), aged 36 to 65 years, from a cohort study at the University of California San Diego. Using the Frontal Systems Behavior Scale, we captured neurobehavioral disturbances (apathy, disinhibition, and executive dysfunction). MetS was defined by the National Cholesterol Education Program’s Adult Treatment Panel-III criteria. Covariates examined included demographic, neurocognitive impairment, and psychiatric characteristics. When controlling for relevant covariates, both HIV serostatus and MetS were independently associated with greater apathy and executive dysfunction. HIV, but not MetS, was associated with greater disinhibition. The present findings suggest an additive effect of HIV and MetS on specific neurobehavioral disturbances (apathy and executive dysfunction), underscoring the importance of identifying and treating both HIV and MetS to lessen central nervous system burden among PLWH.

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Acknowledgements

The views expressed in this article are those of the authors and do not reflect the official policy or position of the Department of the Navy, Department of Defense, nor the United States Government. Portions of the data in this manuscript were presented at the HIV and Aging: From the Mitochondria to the Metropolis conference (April, 2019) Atlanta, GA. There are no conflicts of interest to report. This work was supported in part by the National Institutes of Health (R01MH099987, R25MH108389 [Sustained Training on Aging and HIV Research; STAHR], P30AG059299, K23MH105297, T32 DA031098, P30MH062512 [HIV Neurobehavioral Research Center; HNRC]) and the UC San Diego Sam and Rose Stein Institute for Research on Aging at the University of Calfornia San Diego.

*The San Diego HIV Neurobehavioral Research Center (HNRC) group is affiliated with the University of California, San Diego, the Naval Hospital, San Diego, and the Veterans Affairs San Diego Healthcare System, and includes Director: Robert K. Heaton, Ph.D.; Co-Director: Igor Grant, M.D.; Associate Directors: J. Hampton Atkinson, M.D., Ronald J. Ellis, M.D., Ph.D., and Scott Letendre, M.D.; Center Manager: Jennifer Iudicello, Ph.D.; Donald Franklin, Jr.; Melanie Sherman; NeuroAssessment Core: Ronald J. Ellis, M.D., Ph.D. (P.I.), Scott Letendre, M.D., Thomas D. Marcotte, Ph.D, Christine Fennema-Notestine, Ph.D., Debra Rosario, M.P.H., Matthew Dawson; NeuroBiology Core: Cristian Achim, M.D., Ph.D. (P.I.), Ana Sanchez, Ph.D., Adam Fields, Ph.D.; NeuroGerm Core: Sara Gianella Weibel, M.D. (P.I.), David M. Smith, M.D., Rob Knight, Ph.D., Scott Peterson, Ph.D.; Developmental Core: Scott Letendre, M.D. (P.I.), J. Allen McCutchan; Participant Accrual and Retention Unit: J. Hampton Atkinson, M.D. (P.I.) Susan Little, M.D., Jennifer Marquie-Beck, M.P.H.; Data Management and Information Systems Unit: Lucila Ohno-Machado, Ph.D. (P.I.), Clint Cushman; Statistics Unit: Ian Abramson, Ph.D. (P.I.), Florin Vaida, Ph.D. (Co-PI), Anya Umlauf, M.S., Bin Tang, M.S.

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Authors and Affiliations

  1. Graduate Center for Gerontology, University of Kentucky, 725 Rose Street, Lexington, KY, 40536, USA

    Caitlin N. Pope

  2. Department of Psychiatry, University of California San Diego, San Diego, CA, USA

    Jessica L. Montoya, Dilip V. Jeste, David J. Moore & María J. Marquine

  3. Department of Epidemiology and Biostatistics, School of Public Health, University of Albany State University of New York, Albany, NY, USA

    Elizabeth Vasquez

  4. Division of Cancer Biology, Comprehensive Cancer Center, University of Puerto Rico, San Juan, Puerto Rico

    Josué Pérez-Santiago

  5. Department of Neuroscience, University of California San Diego, San Diego, CA, USA

    Ronald Ellis & Dilip V. Jeste

  6. Department of Medicine, University of California San Diego, San Diego, CA, USA

    J. Allen McCutchan

  7. Stein Institute for Research on Aging, University of California San Diego, San Diego, CA, USA

    Dilip V. Jeste

  8. Department of Psychiatry, UCSD School of Medicine, 9500 Gilman Drive, La Jolla, CA, 92093-0603, USA

    María J. Marquine

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Pope, C.N., Montoya, J.L., Vasquez, E. et al. Association of HIV serostatus and metabolic syndrome with neurobehavioral disturbances. J. Neurovirol. 26, 888–898 (2020). https://doi.org/10.1007/s13365-020-00878-5

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