Abstract
The intersecting epidemics of HIV and hazardous or harmful alcohol use (HAU) can have significant detrimental consequences. Both HIV and HAU have independent negative influences on executive function. Dysfunction in reward processing may play a role in these co-occurring epidemics. In this cross-sectional case–control study, we investigated the association of HAU with reward processing amongst people with HIV (PWH). We investigated the function of the ventral–striatal reward system using a functional MRI (fMRI) monetary incentive delay (MID) task in a sample of 60 South African adults (mean age 32.7 years): 42 living with HIV and on ART (21 with harmful alcohol use [HIV + HAU], 21 without [HIV-HAU]) and 18 healthy controls, matched for age, gender, and resident community. Education significantly influenced task performance, with those with a secondary level of education demonstrating a greater increase in reaction time (p = 0.048) and accuracy (p = 0.002) than those without. There were no significant differences in reward anticipation in the ventral striatum (VS) between HIV + HAU, HIV-HAU, and healthy controls when controlling for level of education. There were also no significant differences in reward outcome in the orbitofrontal cortex (OFC) between HIV + HAU, HIV-HAU, and healthy controls when controlling for level of education. In a sample of South African adults, we did not demonstrate significant differences in reward anticipation in the VS and reward outcome in the OFC in PWH, with and without HAU, and controls. Factors, such as task performance, education, and depression may have influenced our results. Further studies are needed to better delineate the potential links between HIV, HAU, and depression and reward system function.
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Acknowledgements
Sister Letticia Hintsho and Ms. Bulelwa Zibi assisted with recruitment and assessment of participants.
Funding
This work is supported and funded by the South African Research Chair in PTSD awarded to S Seedat and hosted by Stellenbosch University, funded by the DSI, and administered by NRF. Additional research support was provided by The Partnership for AIDS and Alcohol Intervention Research awarded to G Spies. L van den Heuvel was supported by a D43 NIH-Fogarty AIDS comorbidities training fellowship ‘Pittsburgh & Stellenbosch Universities HIV-Associated Cardio-Metabolic, Chronic Kidney and Neuropsychiatry Diseases Research Training Fellowship Programme’.
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Leigh Luella van den Heuvel contributed to formal analysis, writing—original draft, and writing—review and editing. Fatima Ahmed-Leitao contributed to formal analysis. Stefan du Plessis contributed to conceptualisation and writing—review and editing. Graeme Hoddinott contributed to conceptualisation, funding acquisition, and writing—review and editing. Georgina Spies contributed to conceptualisation, data curation, funding acquisition, investigation, methodology, project administration, resources, visualisation, and writing—review and editing. Soraya Seedat contributed to conceptualisation, methodology, project administration, resources, supervision, and writing—review and editing.
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van den Heuvel, L.L., Ahmed-Leitao, F., du Plessis, S. et al. Hazardous or harmful alcohol use and reward processing in people with HIV. J. Neurovirol. 28, 514–526 (2022). https://doi.org/10.1007/s13365-022-01097-w
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DOI: https://doi.org/10.1007/s13365-022-01097-w