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Short Communication: Carotid Intima-Media Thickness Is Not Associated with Neurocognitive Impairment Among People Older than 50 Years With and Without HIV Infection from Thailand.
AIDS Res Hum Retroviruses 2019 Nov/Dec; 35(11-12):1170-1173AR

Abstract

Neurocognitive impairment (NCI) contributes to poor quality of life among HIV-positive individuals. Cardiovascular risk factors, including the predictor of subclinical atherosclerosis, carotid intima-media thickness (cIMT), are reported to be associated with NCI. Data on NCI and its association with cIMT among HIV positive are limited, especially in Asian populations. We aimed to determine the prevalence of NCI and its association with cIMT among HIV-positive and HIV-negative aging Thai individuals. Cognitive performance was evaluated by the Thai version of Montreal Cognitive Assessment (MoCA) with a cutoff of <25/30 for diagnosis of NCI. Depression was evaluated by PHQ-9 Patient Depression Questionnaire, with scores ≥5 indicating depression. cIMT measurement was performed by experienced neurologists, and abnormal cIMT was defined as cIMT ≥0.9 mm or presence of carotid plaques. Among 340 well suppressed and aging HIV-positive and 102 HIV-negative matched participants, the median age (interquartile range) was 55 (52-59) years and 61.5% were males. For HIV positive group, the median duration on antiretroviral therapy was 18.3 years with median CD4 of 615.5 cells/mm3, and 97.4% had current plasma HIV RNA <50 copies/mL. The most common antiretroviral agents used were tenofovir disoproxil fumarate (76.8%), lamivudine (70.3%), efavirenz (26.7%), and emtricitabine (23.8%). HIV-positive and HIV-negative participants performed comparably between each domain and had comparable prevalence of NCI (59.4% vs. 61.7%, p = .69). However, the HIV-positive group had a high prevalence of depression (24.71% vs. 13.73%, p = .019). HIV-positive status [adjusted odd ratio (aOR) 0.91; 95% confidence interval (CI) 0.57-1.47, p = .71] and cIMT (aOR 1.17; 95% CI 0.77-1.79, p = .47) were not significantly associated with NCI. Given the high prevalence of NCI and depression among aging HIV-positive individuals, routine screening for NCI and depression should be integrated into the HIV care services.

Authors+Show Affiliations

HIV Netherlands Australia Thailand Research Collaboration (HIV-NAT), Thai Red Cross - AIDS Research Centre, Bangkok, Thailand. Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand. Division of Neurology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.Division of Neurology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand. Chulalongkorn Stroke Center, King Chulalongkorn Memorial Hospital, Bangkok, Thailand.HIV Netherlands Australia Thailand Research Collaboration (HIV-NAT), Thai Red Cross - AIDS Research Centre, Bangkok, Thailand.Division of Neurology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand. Chulalongkorn Stroke Center, King Chulalongkorn Memorial Hospital, Bangkok, Thailand.Division of Neurology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand. Chulalongkorn Stroke Center, King Chulalongkorn Memorial Hospital, Bangkok, Thailand.Division of Neurology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand. Chulalongkorn Stroke Center, King Chulalongkorn Memorial Hospital, Bangkok, Thailand.Division of Neurology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand. Chulalongkorn Stroke Center, King Chulalongkorn Memorial Hospital, Bangkok, Thailand.HIV Netherlands Australia Thailand Research Collaboration (HIV-NAT), Thai Red Cross - AIDS Research Centre, Bangkok, Thailand.HIV Netherlands Australia Thailand Research Collaboration (HIV-NAT), Thai Red Cross - AIDS Research Centre, Bangkok, Thailand.HIV Netherlands Australia Thailand Research Collaboration (HIV-NAT), Thai Red Cross - AIDS Research Centre, Bangkok, Thailand. Tuberculosis Research Unit, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.HIV Netherlands Australia Thailand Research Collaboration (HIV-NAT), Thai Red Cross - AIDS Research Centre, Bangkok, Thailand.Division of Cardiovascular Medicine, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.HIV Netherlands Australia Thailand Research Collaboration (HIV-NAT), Thai Red Cross - AIDS Research Centre, Bangkok, Thailand. Biostatistics Excellence Centre, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.HIV Netherlands Australia Thailand Research Collaboration (HIV-NAT), Thai Red Cross - AIDS Research Centre, Bangkok, Thailand. Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.HIV Netherlands Australia Thailand Research Collaboration (HIV-NAT), Thai Red Cross - AIDS Research Centre, Bangkok, Thailand. Tuberculosis Research Unit, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31588776

Citation

Hiransuthikul, Akarin, et al. "Short Communication: Carotid Intima-Media Thickness Is Not Associated With Neurocognitive Impairment Among People Older Than 50 Years With and Without HIV Infection From Thailand." AIDS Research and Human Retroviruses, vol. 35, no. 11-12, 2019, pp. 1170-1173.
Hiransuthikul A, Chutinet A, Sakulrak S, et al. Short Communication: Carotid Intima-Media Thickness Is Not Associated with Neurocognitive Impairment Among People Older than 50 Years With and Without HIV Infection from Thailand. AIDS Res Hum Retroviruses. 2019;35(11-12):1170-1173.
Hiransuthikul, A., Chutinet, A., Sakulrak, S., Samajarn, J., Vongsayan, P., Kijpaisalratana, N., ... Avihingsanon, A. (2019). Short Communication: Carotid Intima-Media Thickness Is Not Associated with Neurocognitive Impairment Among People Older than 50 Years With and Without HIV Infection from Thailand. AIDS Research and Human Retroviruses, 35(11-12), pp. 1170-1173. doi:10.1089/AID.2019.0139.
Hiransuthikul A, et al. Short Communication: Carotid Intima-Media Thickness Is Not Associated With Neurocognitive Impairment Among People Older Than 50 Years With and Without HIV Infection From Thailand. AIDS Res Hum Retroviruses. 2019;35(11-12):1170-1173. PubMed PMID: 31588776.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Short Communication: Carotid Intima-Media Thickness Is Not Associated with Neurocognitive Impairment Among People Older than 50 Years With and Without HIV Infection from Thailand. AU - Hiransuthikul,Akarin, AU - Chutinet,Aurauma, AU - Sakulrak,Salila, AU - Samajarn,Jitlada, AU - Vongsayan,Pongpat, AU - Kijpaisalratana,Naruchorn, AU - Akarathanawat,Wasan, AU - Apornpong,Tanakorn, AU - Sangarlangkarn,Aroonsiri, AU - Gatechompol,Sivaporn, AU - Han,Win Min, AU - Chattranukulchai,Pairoj, AU - Kerr,Stephen, AU - Ruxrungtham,Kiat, AU - Avihingsanon,Anchalee, PY - 2019/10/8/pubmed PY - 2019/10/8/medline PY - 2019/10/8/entrez KW - HIV KW - aging KW - carotid intima-media thickness KW - neurocognitive SP - 1170 EP - 1173 JF - AIDS research and human retroviruses JO - AIDS Res. Hum. Retroviruses VL - 35 IS - 11-12 N2 - Neurocognitive impairment (NCI) contributes to poor quality of life among HIV-positive individuals. Cardiovascular risk factors, including the predictor of subclinical atherosclerosis, carotid intima-media thickness (cIMT), are reported to be associated with NCI. Data on NCI and its association with cIMT among HIV positive are limited, especially in Asian populations. We aimed to determine the prevalence of NCI and its association with cIMT among HIV-positive and HIV-negative aging Thai individuals. Cognitive performance was evaluated by the Thai version of Montreal Cognitive Assessment (MoCA) with a cutoff of <25/30 for diagnosis of NCI. Depression was evaluated by PHQ-9 Patient Depression Questionnaire, with scores ≥5 indicating depression. cIMT measurement was performed by experienced neurologists, and abnormal cIMT was defined as cIMT ≥0.9 mm or presence of carotid plaques. Among 340 well suppressed and aging HIV-positive and 102 HIV-negative matched participants, the median age (interquartile range) was 55 (52-59) years and 61.5% were males. For HIV positive group, the median duration on antiretroviral therapy was 18.3 years with median CD4 of 615.5 cells/mm3, and 97.4% had current plasma HIV RNA <50 copies/mL. The most common antiretroviral agents used were tenofovir disoproxil fumarate (76.8%), lamivudine (70.3%), efavirenz (26.7%), and emtricitabine (23.8%). HIV-positive and HIV-negative participants performed comparably between each domain and had comparable prevalence of NCI (59.4% vs. 61.7%, p = .69). However, the HIV-positive group had a high prevalence of depression (24.71% vs. 13.73%, p = .019). HIV-positive status [adjusted odd ratio (aOR) 0.91; 95% confidence interval (CI) 0.57-1.47, p = .71] and cIMT (aOR 1.17; 95% CI 0.77-1.79, p = .47) were not significantly associated with NCI. Given the high prevalence of NCI and depression among aging HIV-positive individuals, routine screening for NCI and depression should be integrated into the HIV care services. SN - 1931-8405 UR - https://www.unboundmedicine.com/medline/citation/31588776/Carotid_intima-media_thickness_is_not_associated_with_neurocognitive_impairment_among_people_older_than_50_years_with_and_without_HIV_infection_from_Thailand L2 - https://www.liebertpub.com/doi/full/10.1089/AID.2019.0139?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -