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Cardiovascular risk factors and carotid intima-media thickness are associated with lower cognitive performance in HIV-infected patients.
HIV Med 2013; 14(3):136-44HM

Abstract

OBJECTIVES

The aim of the study was to investigate the relationship between metabolic comorbidities, cardiovascular risk factors or common carotid intima-media thickness (cIMT) and cognitive performance in HIV-infected patients.

METHODS

Asymptomatic HIV-infected subjects were consecutively enrolled during routine out-patient visits at two clinical centres. All patients underwent an extensive neuropsychological battery and assessment of metabolic comorbidities and cardiovascular risk factors. Moreover, cIMT was assessed by ultrasonography. Cognitive performance was evaluated by calculating a global cognitive impairment (GCI) score obtained by summing scores assigned to each test (0 if normal and 1 if pathological).

RESULTS

A total of 245 patients (median age 46 years; 84.1% with HIV RNA < 50 copies/mL; median CD4 count 527 cells/μL) were enrolled in the study. Cardiovascular risk factors were highly prevalent in our population: the most frequent were dyslipidaemia (61.2%), cigarette smoking (54.3%) and hypertension (15.1%). cIMT was abnormal (≥ 0.9mm) in 31.8% of patients. Overall, the median GCI score was 2 [interquartile range (IQR) 1-4]; it was higher in patients with diabetes (P = 0.004), hypertension (P = 0.030) or cIMT ≥ 0.9 mm (P < 0.001). In multivariate analysis, it was confirmed that diabetes (P = 0.007) and cIMT ≥ 0.9 mm (P = 0.044) had an independent association with lower cognitive performance. In an analysis of patients on combination antiretroviral therapy (cART), abacavir use was independently associated with a better cognitive performance (P = 0.011), while no association was observed for other drugs or neuroeffectiveness score.

CONCLUSIONS

Diabetes, cardiovascular risk factors and cIMT showed a strong association with lower cognitive performance, suggesting that metabolic comorbidities could play a relevant role in the pathogenesis of HIV-associated neurocognitive disorders in the recent cART era.

Authors+Show Affiliations

Institute of Clinical Infectious Diseases, Catholic University of Sacred Heart, Rome, Italy. massifab@alice.itNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

22994586

Citation

Fabbiani, M, et al. "Cardiovascular Risk Factors and Carotid Intima-media Thickness Are Associated With Lower Cognitive Performance in HIV-infected Patients." HIV Medicine, vol. 14, no. 3, 2013, pp. 136-44.
Fabbiani M, Ciccarelli N, Tana M, et al. Cardiovascular risk factors and carotid intima-media thickness are associated with lower cognitive performance in HIV-infected patients. HIV Med. 2013;14(3):136-44.
Fabbiani, M., Ciccarelli, N., Tana, M., Farina, S., Baldonero, E., Di Cristo, V., ... Di Giambenedetto, S. (2013). Cardiovascular risk factors and carotid intima-media thickness are associated with lower cognitive performance in HIV-infected patients. HIV Medicine, 14(3), pp. 136-44. doi:10.1111/j.1468-1293.2012.01044.x.
Fabbiani M, et al. Cardiovascular Risk Factors and Carotid Intima-media Thickness Are Associated With Lower Cognitive Performance in HIV-infected Patients. HIV Med. 2013;14(3):136-44. PubMed PMID: 22994586.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cardiovascular risk factors and carotid intima-media thickness are associated with lower cognitive performance in HIV-infected patients. AU - Fabbiani,M, AU - Ciccarelli,N, AU - Tana,M, AU - Farina,S, AU - Baldonero,E, AU - Di Cristo,V, AU - Colafigli,M, AU - Tamburrini,E, AU - Cauda,R, AU - Silveri,M C, AU - Grima,P, AU - Di Giambenedetto,S, Y1 - 2012/09/21/ PY - 2012/07/27/accepted PY - 2012/9/22/entrez PY - 2012/9/22/pubmed PY - 2013/7/31/medline SP - 136 EP - 44 JF - HIV medicine JO - HIV Med. VL - 14 IS - 3 N2 - OBJECTIVES: The aim of the study was to investigate the relationship between metabolic comorbidities, cardiovascular risk factors or common carotid intima-media thickness (cIMT) and cognitive performance in HIV-infected patients. METHODS: Asymptomatic HIV-infected subjects were consecutively enrolled during routine out-patient visits at two clinical centres. All patients underwent an extensive neuropsychological battery and assessment of metabolic comorbidities and cardiovascular risk factors. Moreover, cIMT was assessed by ultrasonography. Cognitive performance was evaluated by calculating a global cognitive impairment (GCI) score obtained by summing scores assigned to each test (0 if normal and 1 if pathological). RESULTS: A total of 245 patients (median age 46 years; 84.1% with HIV RNA < 50 copies/mL; median CD4 count 527 cells/μL) were enrolled in the study. Cardiovascular risk factors were highly prevalent in our population: the most frequent were dyslipidaemia (61.2%), cigarette smoking (54.3%) and hypertension (15.1%). cIMT was abnormal (≥ 0.9mm) in 31.8% of patients. Overall, the median GCI score was 2 [interquartile range (IQR) 1-4]; it was higher in patients with diabetes (P = 0.004), hypertension (P = 0.030) or cIMT ≥ 0.9 mm (P < 0.001). In multivariate analysis, it was confirmed that diabetes (P = 0.007) and cIMT ≥ 0.9 mm (P = 0.044) had an independent association with lower cognitive performance. In an analysis of patients on combination antiretroviral therapy (cART), abacavir use was independently associated with a better cognitive performance (P = 0.011), while no association was observed for other drugs or neuroeffectiveness score. CONCLUSIONS: Diabetes, cardiovascular risk factors and cIMT showed a strong association with lower cognitive performance, suggesting that metabolic comorbidities could play a relevant role in the pathogenesis of HIV-associated neurocognitive disorders in the recent cART era. SN - 1468-1293 UR - https://www.unboundmedicine.com/medline/citation/22994586/Cardiovascular_risk_factors_and_carotid_intima_media_thickness_are_associated_with_lower_cognitive_performance_in_HIV_infected_patients_ L2 - https://doi.org/10.1111/j.1468-1293.2012.01044.x DB - PRIME DP - Unbound Medicine ER -