4
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: not found
      • Article: not found

      The Veterans Aging Cohort Study Index is Associated With Concurrent Risk for Neurocognitive Impairment :

      Read this article at

      ScienceOpenPublisherPMC
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          The Veterans Aging Cohort Study (VACS) Index is predictive of mortality and combines age, traditional HIV biomarkers (HIV-1 plasma RNA and current CD4 count), and non-HIV biomarkers (indicators of renal and liver function, anemia, and hepatitis C coinfection). We examined the association between the VACS Index and HIV-associated neurocognitive impairment (NCI).

          Related collections

          Most cited references33

          • Record: found
          • Abstract: found
          • Article: not found

          Role of inflammation in cognitive impairment: results of observational epidemiological studies and clinical trials.

          Inflammation may be an important mechanism underlying dementia and cognitive decline in the elderly. Inflammation has been implicated in the neuropathological cascade leading to the development of Alzheimer's disease and other common forms of dementia in later life. These observations have led to observational epidemiological study to define the association of systemic and brain inflammatory markers on cognitive impairment and dementia. Furthermore, clinical trials have been carried out to better elucidate the possible role of nonsteroidal anti-inflammatory drugs (NSAIDs) in the prevention or slowing of progression of Alzheimer's disease. In this review, we discuss the observational epidemiological and clinical trial evidence of the role of inflammation on the occurrence and prevention of dementia or cognitive decline. NSAIDs hold promise to prevent dementia if given in an appropriate time window during the induction phase of dementia and to subjects with apolipoprotein E (APOE) e4 alleles. Also, immunotherapy may prove beneficial. © 2010 New York Academy of Sciences.
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            CD4 nadir is a predictor of HIV neurocognitive impairment in the era of combination antiretroviral therapy.

            Despite immune recovery in individuals on combination antiretroviral therapy (CART), the frequency of HIV-associated neurocognitive disorders (HANDs) remains high. Immune recovery is typically achieved after initiation of ART from the nadir, or the lowest historical CD4. The present study evaluated the probability of neuropsychological impairment (NPI) and HAND as a function of CD4 nadir in an HIV-positive cohort. One thousand five hundred and twenty-five HIV-positive participants enrolled in CNS HIV Antiretroviral Therapy Effects Research, a multisite, observational study that completed comprehensive neurobehavioral and neuromedical evaluations, including a neurocognitive test battery covering seven cognitive domains. Among impaired individuals, HAND was diagnosed if NPI could not be attributed to comorbidities. CD4 nadir was obtained by self-report or observation. Potential modifiers of the relationship between CD4 nadir and HAND, including demographic and HIV disease characteristics, were assessed in univariate and multivariate analyses. The median CD4 nadir (cells/μl) was 172, and 52% had NPI. Among impaired participants, 603 (75%) had HAND. Higher CD4 nadirs were associated with lower odds of NPI such that for every 5-unit increase in square-root CD4 nadir, the odds of NPI were reduced by 10%. In 589 virally suppressed participants on ART, higher CD4 nadir was associated with lower odds of NPI after adjusting for demographic and clinical factors. As the risk of NPI was lowest in patients whose CD4 cell count was never allowed to fall to low levels before CART initiation, our findings suggest that initiation of CART as early as possible might reduce the risk of developing HAND, the most common source of NPI among HIV-infected individuals.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Higher frequency of dementia in older HIV-1 individuals: the Hawaii Aging with HIV-1 Cohort.

              Antiretroviral therapy has improved survival for HIV-1-infected individuals. The neuroepidemiologic implications of HIV-1 in an aging population are not well known, particularly the prevalence of HIV-associated dementia (HAD). The authors report a baseline cross-sectional analysis of 202 HIV-1-seropositive individuals enrolled into one of two groups of the Hawaii Aging with HIV Cohort: older (50 or more years old, n = 106) and younger (20 to 39 years old, n = 96). Neuropsychological, neurologic, medical, and laboratory data were obtained at enrollment. Participant cognitive status was classified (research case definitions) using American Academy of Neurology (1991) criteria in a consensus conference of physicians and neuropsychologists. HAD was more frequent in older (25.2%) compared to younger (13.7%) individuals (p = 0.041) corresponding to an OR of 2.13 (95% CI: 1.02 to 4.44) for the older compared to the younger group. After adjusting for education, race, substance dependence, antiretroviral medication status, viral load, CD4 lymphocyte count, and Beck Depression Inventory score, the odds of having HAD among individuals in the older group was 3.26 (1.32 to 8.07) times that of the younger group. Older age is associated with increased HAD in this HIV-1 cohort. Underlying mechanisms are unclear but do not appear related to duration of HIV-1 infection.
                Bookmark

                Author and article information

                Journal
                JAIDS Journal of Acquired Immune Deficiency Syndromes
                JAIDS Journal of Acquired Immune Deficiency Syndromes
                Ovid Technologies (Wolters Kluwer Health)
                1525-4135
                2014
                February 2014
                : 65
                : 2
                : 190-197
                Article
                10.1097/QAI.0000000000000008
                3907119
                24442225
                5325fa77-ca05-47d4-8655-ede0c886563e
                © 2014
                History

                Comments

                Comment on this article