Case Western Reserve University, School of Medicine, OH, USA.
University Hospitals Cleveland Medical Center, Cleveland, OH, USA.
Medicine (Baltimore). 2022 Oct 21;101(42):e31125. doi: 10.1097/MD.0000000000031125.
To compare the neurocognitive scores between persons living with human immunodeficiency virus (PLWH) and persons without human immunodeficiency virus (HIV) and assess the relationship between neurocognition, HIV status and variables, inflammation, and body composition measures. Cross-sectional study involving 225 participants (126 PLWH on antiretroviral therapy [ART] and 99 persons without HIV). For the first time in HIV, we used Cognivue®, an food and drug administration (FDA)-approved computer-based test to assess cognitive function. The test was calibrated to individuals' unique cognitive ability and measured 6 cognitive domains and 2 performance parameters. Markers of inflammation, immune activation, insulin resistance, and body fat composition (using dual-energy X-ray absorptiometry scan) were collected. Classical t tests, chi-square tests, and spearman correlations were used to compare and explore relationships between variables. Inverse probability weighting adjusted average treatment effect models were performed to evaluate the differences between PLWH and persons without HIV, adjusting for age, race, sex, and heroin use. Overall, 64% were male, 46% were Black, with a mean age of 43 years. Among PLWH, 83% had an undetectable HIV-1 RNA level (≤20 copies/mL). Compared persons without HIV, PLWH performed poorer across 4 domains: visuospatial (P = .035), executive function (P = .029), naming/language (P = .027), and abstraction (P = .018). In addition, PLWH had a significantly longer processing speed time compared to controls (1686.0 ms vs 1606.0 ms [P = .007]). In PLWH, lower cognitive testing domain scores were associated with higher inflammatory markers (high sensitivity C-reactive protein [hsCRP]) and with higher total fat and visceral adipose tissue (P < .05). Neurocognitive impairment (NCI) in HIV is associated with inflammation and total and central adiposity.
比较人类免疫缺陷病毒（HIV）感染者和未感染者的神经认知评分，并评估神经认知、HIV 状况与炎症、身体成分测量指标之间的关系。这是一项包含 225 名参与者的横断面研究（126 名接受抗逆转录病毒治疗（ART）的 HIV 感染者和 99 名未感染 HIV 的人）。这是首次在 HIV 中使用 Cognivue®，这是一种获得食品和药物管理局（FDA）批准的计算机化测试，用于评估认知功能。该测试针对个体的独特认知能力进行校准，测量了 6 个认知领域和 2 个绩效参数。收集了炎症、免疫激活、胰岛素抵抗和体脂肪成分（使用双能 X 射线吸收法扫描）的标志物。使用经典 t 检验、卡方检验和斯皮尔曼相关性分析来比较和探索变量之间的关系。采用逆概率加权调整后的平均处理效应模型，调整年龄、种族、性别和海洛因使用情况后，评估 HIV 感染者和未感染者之间的差异。总体而言，64%为男性，46%为黑人，平均年龄为 43 岁。在 HIV 感染者中，83%的人 HIV-1 RNA 水平无法检测到（≤20 拷贝/mL）。与未感染 HIV 的人相比，HIV 感染者在 4 个领域的表现更差：视觉空间（P =.035）、执行功能（P =.029）、命名/语言（P =.027）和抽象（P =.018）。此外，与对照组相比，HIV 感染者的处理速度明显更慢（1686.0ms 比 1606.0ms[P =.007]）。在 HIV 感染者中，较低的认知测试领域评分与更高的炎症标志物（高敏 C 反应蛋白（hsCRP））和更高的总脂肪和内脏脂肪组织呈正相关（P <.05）。HIV 中的神经认知障碍（NCI）与炎症以及全身和中心性肥胖有关。
