JAIDS Journal of Acquired Immune Deficiency Syndromes最新文献

{"title":"Factors Associated With Symptoms of Anxiety and Depression in People Living With HIV in Northeast Brazil","authors":"Gilmara Holanda da Cunha, Marina Soares Monteiro Fontenele, Marli Teresinha Gimeniz Galvão, Maiara Bezerra Dantas, Maria Elisa Curado Gomes, F. V. Fechine, Simone de Sousa Paiva","doi":"10.1097/qai.0000000000003468","DOIUrl":"https://doi.org/10.1097/qai.0000000000003468","url":null,"abstract":"\u0000 \u0000 The diagnosis of HIV infection can cause mental disorders or exacerbate existing symptoms, because of the stigma, psychological stress and need for the self-management of the illness. The aim of this study was to determine the prevalence of anxiety and depression symptoms in people with HIV and to identify the associated factors.\u0000 \u0000 \u0000 \u0000 This is a cross-sectional study. A sample of 385 PLWH was interviewed using the Sociodemographic, Epidemiological and Clinical Form, the Beck Anxiety Inventory, the Beck Depression Inventory and Pittsburgh Sleep Quality Index. Univariate and multivariate logistic regression analysis were performed. The odds ratio and 95% confidence interval were calculated.\u0000 \u0000 \u0000 \u0000 The prevalence of anxiety was 27.1% and depression was 39.8%. Being female (p=0.0227), antiretroviral therapy (ART) for eight years or less (p=0.0042) and having depression (p<0.0001) were associated with the occurrence of anxiety. Having a detectable viral load (p=0.0476), not exercising regularly (p=0.0070), having sleep disorders (p=0.0001) and anxiety (p<0.0001) were associated with depression. Retired and on leave or sick pay were respectively 2.67 and 3.90 times more likely to have depression than those who were employed.\u0000 \u0000 \u0000 \u0000 A considerable percentage of PLWH have anxiety and depression symptoms. Being female, less than eight years of ART and depression are associated with anxiety, while detectable viral load, not practicing physical exercise, having sleep disorders, anxiety and being retired or on leave or sick pay are associated with depression. The study showed important data for health interventions by members of the multidisciplinary team for PLWH.\u0000","PeriodicalId":508427,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":"101 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141361455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PREVALENCE AND CORRELATES OF SARS-COV-2 VACCINE UPTAKE AND HESITANCY AMONG PEOPLE WITH HIV ACROSS THE U.S.","authors":"Matthew A. Spinelli, Mallory O Johnson, Nadra E. Lisha, Jennifer P. Jain, Carlos V. Moreira, David V. Glidden, G. Burkholder, Heidi M Crane, Jeffrey M Jacobson, E. Cachay, Kenneth H. Mayer, S. Napravnik, Richard D. Moore, Monica Gandhi, K. Christopoulos","doi":"10.1097/qai.0000000000003466","DOIUrl":"https://doi.org/10.1097/qai.0000000000003466","url":null,"abstract":"\u0000 \u0000 People with HIV (PWH) have higher risk of COVID-19 mortality. SARS-CoV-2 vaccination is highly effective among PWH, although vaccine hesitancy could limit the population-level impact.\u0000 \u0000 \u0000 \u0000 From 2/2021-4/2022, PWH from 8 sites in the Centers for AIDS Research Network of Integrated Clinical Systems (CNICS) completed a vaccine hesitancy instrument as part of routine care.\u0000 \u0000 \u0000 \u0000 Participants were defined as vaccine hesitant if they had not received the SARS-CoV-2 vaccine and would probably/definitely not receive it. We assessed factors associated with SARS-CoV-2 vaccine hesitancy using logistic regression adjusted for demographics, unsuppressed viral load (VL>200 copies/mL), month, and time on ART; using inverse probability weighting for survey non-response.\u0000 \u0000 \u0000 \u0000 Overall, 3,288 PWH with a median age of 55 were included; 18% were female and 94% were virally suppressed. At the time of survey, 27% reported they had not received the SARS-CoV-2 vaccine, and 9% (n=279) reported vaccine hesitancy. Factors associated with vaccine hesitancy included female sex (Adjusted Odds Ratio [AOR]=2.3; 95% Confidence Interval (CI)=1.6-3.2), Black vs. White race (AOR 1.7; 95% CI=1.2-2.4), younger age (AOR 1.4; 95% CI=1.2-1.5), and unsuppressed VL (AOR 1.9; 95% CI=1.3-3.0).\u0000 \u0000 \u0000 \u0000 Overall, over one-quarter of PWH in this multisite cohort were unvaccinated for SARS-CoV-2 when interviewed 2/21-4/22. Vaccine hesitancy was reported by approximately 9% of PWH, and was higher among women, Black PWH, younger PWH, PWH with unsuppressed VL, and those in the South/Midwest. Renewed efforts are needed to address concerns of PWH about vaccinations against COVID-19 as the pandemic evolves, and vaccines in general, given the potential for future pandemics.\u0000","PeriodicalId":508427,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":"20 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141379878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lower neutrophil count without clinical consequence among children of African ancestry living with HIV in Canada","authors":"Isabelle Bernard, D. Ransy, Jason Brophy, Fatima Kakkar, Ari Bitnun, Laura Sauvé, L. Samson, Stanley Read, Hugo Soudeyns, Michael T Hawkes","doi":"10.1097/qai.0000000000003467","DOIUrl":"https://doi.org/10.1097/qai.0000000000003467","url":null,"abstract":"\u0000 \u0000 To investigate the association between African ancestry and neutrophil counts among children living with HIV (CLWH). We also examined whether medications, clinical conditions, hospitalization, or HIV virologic control were associated with low neutrophil counts or African ancestry.\u0000 \u0000 \u0000 \u0000 We conducted a secondary analysis of the Early Pediatric Initiation Canada Child Cure Cohort (EPIC4) Study, a multicenter prospective cohort study of CLWH across eight Canadian pediatric HIV care centers.\u0000 \u0000 \u0000 \u0000 We classified CLWH according to African ancestry, defined as “African,” “Caribbean” or “Black” maternal race. Longitudinal laboratory data (white blood cells (WBCs), neutrophils, lymphocytes, viral load, CD4 count) and clinical data (hospitalizations, AIDS-defining conditions, treatments) were abstracted from medical records.\u0000 \u0000 \u0000 \u0000 Among 217 CLWH (median age 14, 55% female), 145 were of African ancestry and 72 were of non-African ancestry. African ancestry was associated with lower neutrophil counts, WBC counts, and neutrophil-lymphocyte ratios. Neutrophil count<1.5×109/L was detected in 60% of CLWH of African ancestry, compared to 31% of CLWH of non-African ancestry (p<0.0001), representing a 2.0-fold higher relative frequency (95% CI 1.4-2.9). Neutrophil count was on average 0.74×109/L (95%CI 0.45-1.0) lower in CLWH of African ancestry (p<0.0001). Neither neutrophil count<1.5×109/L nor African ancestry was associated with medications, hospitalizations, AIDS-defining conditions, or markers of virologic control (viral load, sustained viral suppression, lifetime nadir CD4).\u0000 \u0000 \u0000 \u0000 In CLWH, African ancestry is associated with lower neutrophil counts, without clinical consequences. A flexible evaluation of neutrophil counts in CLWH of African ancestry may avoid unnecessary interventions.\u0000","PeriodicalId":508427,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":"315 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141386175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reaching for 90:90:90 in correctional facilities in South Africa and Zambia: Virtual cross-section of coverage of HIV testing and antiretroviral therapy during universal test and treat implementation","authors":"Christopher J Hoffmann, M. Herce, L. Chimoyi, Helene Smith, M. Tlali, Cobus J Olivier, Stephanie M Topp, Monde Muyoyeta, Stewart E Reid, Harry Hausler, S. Charalambous, Katherine L. Fielding","doi":"10.1097/qai.0000000000003456","DOIUrl":"https://doi.org/10.1097/qai.0000000000003456","url":null,"abstract":"\u0000 \u0000 People in correctional settings are a key population for HIV epidemic control. We sought to demonstrate scale-up of universal test and treat (UTT) in correctional facilities in South Africa and Zambia through a virtual cross-sectional analysis.\u0000 \u0000 \u0000 \u0000 We used routine data on two dates: at the start of UTT implementation (time 1, T1) and one year later (time 2, T2). We obtained correctional facility census lists for the selected dates and matched HIV testing and treatment data to generate virtual cross-sections of HIV care continuum indicators.\u0000 \u0000 \u0000 \u0000 In the South African site, there were 4,193 and 3,868 people in the facility at times T1 and T2; 43% and 36% were matched with HIV testing or treatment data, respectively. At T1 and T2, respectively, 1803 (43%) and 1,386 (36%) had known HIV status, 804 (19%) and 845 (21%) were known to be living with HIV, and 60% and 56% of those with known HIV were receiving antiretroviral therapy (ART). In the Zambian site, there were 1,467 and 1,366 people in the facility at times T1 and T2; 58% and 92% were matched with HIV testing or treatment data, respectively. At T1 and T2, respectively, 857 (59%) and 1263 (92%) had known HIV status, 277 (19%) and 647 (47%) were known to be living with HIV, and 68% and 68% of those with known HIV were receiving ART.\u0000 \u0000 \u0000 \u0000 This virtual cross-sectional analysis identified gaps in HIV testing coverage and ART initiation not clearly demonstrated by prior cohort-based studies.\u0000","PeriodicalId":508427,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":"55 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141384216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Youth who acquired HIV perinatally have poorer viral suppression than those who acquired HIV later in life: findings from a population survey in Zimbabwe","authors":"Victoria Simms, Katharina Kranzer, C. D. Chikwari, E. Dauya, Tsitsi BandasonMSc, N. Dzavakwa, R. Ferrand","doi":"10.1097/qai.0000000000003459","DOIUrl":"https://doi.org/10.1097/qai.0000000000003459","url":null,"abstract":"\u0000 \u0000 Perinatally acquired HIV may lead to worse health outcomes compared to later acquisition. We compared the demographic and clinical characteristics of youth diagnosed with HIV in childhood and adulthood, as a proxy for acquisition route (perinatal vs horizontal).\u0000 \u0000 \u0000 \u0000 Youth aged 18-24 years in 3 provinces in Zimbabwe\u0000 \u0000 \u0000 \u0000 In a representative population-based survey, participants were asked their HIV status, date of HIV diagnosis if positive, and whether they were diagnosed in childhood. A dried blood spot was taken to measure viral load. Multilevel mixed-effects generalized linear modelling was used to estimate the association between HIV acquisition time and viral non-suppression (≥1000 copies/ml).\u0000 \u0000 \u0000 \u0000 17,682 participants (60.8% female) were enrolled, 17553 (99.3%) gave a DBS sample, 1200 (6.8%) tested HIV antibody positive (7 indeterminate results) and 26 reported being HIV positive without confirmation. Of the 1226 participants living with HIV, 435 (35.5%) self-reported they were HIV-positive, of whom 196 (45.1%) were diagnosed in childhood (median age 7 years).\u0000 A higher proportion of adult-diagnosed than child-diagnosed participants were female (91.2% vs 76.5%), had ever had sex (93.3% vs 61.5%), been married/cohabiting (59.4% vs 19.4%) and been pregnant (78.9% of women vs 40.0%). A lower proportion had viral suppression (39.3% vs 52.5%). Adjusting for sex, age, marital status and education, those diagnosed as children had higher odds of viral non-suppression (adjusted odds ratio=1.83, 95%CI 1.17-2.85, p=0.008).\u0000 \u0000 \u0000 \u0000 Youth who acquired HIV perinatally have differentiated care needs and greater risk of viral non-suppression compared to those who acquired HIV later.\u0000","PeriodicalId":508427,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":" 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140992446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pre-exposure prophylaxis awareness and use among transgender and non-binary individuals in Canada.","authors":"Jason Hallarn, A. Scheim, Greta R. Bauer","doi":"10.1097/qai.0000000000003443","DOIUrl":"https://doi.org/10.1097/qai.0000000000003443","url":null,"abstract":"","PeriodicalId":508427,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":" 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140997271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations of CD4 cell count measures with infection-related and infection-unrelated cancer risk among people with HIV","authors":"Ioana A. Nicolau, Rahim Moineddin, Jennifer D. Brooks, Tony Antoniou, Jennifer L. Gillis, Claire E. Kendall, Curtis Cooper, Michelle Cotterchio, Kate Salters, Marek Smieja, A. Kroch, Colleen Price, Anthony Mohamed, Ann N. Burchell","doi":"10.1097/qai.0000000000003452","DOIUrl":"https://doi.org/10.1097/qai.0000000000003452","url":null,"abstract":"\u0000 \u0000 People with human immunodeficiency virus (HIV) are at higher risk of infection-related cancers than the general population which could be due, in part, to immune dysfunction. Our objective was to examine associations between four CD4 count measures as indicators of immune function and infection-related and -unrelated cancer risk.\u0000 \u0000 \u0000 \u0000 We conducted a cohort study of adults with HIV who were diagnosed with cancer in Ontario, Canada. Incident cancers were identified from January 1, 1997 to December 31, 2020.\u0000 \u0000 \u0000 \u0000 We estimated adjusted hazard ratios (aHR) for the associations between CD4 measures (baseline CD4, nadir CD4, time-updated CD4, time-updated CD4:CD8) and cancer incidence rates using competing risk analyses, adjusted for socio-demographic factors, history of hepatitis B or C infection, baseline viral load, smoking, and alcohol use.\u0000 \u0000 \u0000 \u0000 Among 4,771 people with HIV, contributing 59,111 person-years of observation, a total of 549 cancers were observed. Low baseline CD4 (<200 cells/µL) (aHR 2.08 [95% CI 1.38-3.13], nadir (<200 cells/µL) (aHR 2.01 [95% CI 1.49-2.71]), low time-updated CD4 (aHR 3.52 [95% CI 2.36-5.24]) and time-updated CD4:CD8 ratio (<0.4) (aHR 2.02 [95% CI 1.08-3.79]) were associated with an increased rate of infection-related cancer. No associations were observed for infection-unrelated cancers.\u0000 \u0000 \u0000 \u0000 Low CD4 counts and indices were associated with increased rates of infection-related cancers among people with HIV, irrespective of the CD4 measure used. Early diagnosis and linkage to care and high antiretroviral therapy uptake may lead to improved immune function and could add to cancer prevention strategies such as screening and vaccine uptake.\u0000","PeriodicalId":508427,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":" 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140996987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the Efficacy of Psycho-Behavioral Interventions for Cardiovascular Risk among People Living with HIV: A Systematic Review and Meta-Synthesis of Randomized Controlled Trials","authors":"Jacklyn D. Foley, Lauren B. Bernier, Long Ngo, Abigail W. Batchelder, C. O’Cleirigh, Melissa Lydston, Gloria Yeh","doi":"10.1097/qai.0000000000003441","DOIUrl":"https://doi.org/10.1097/qai.0000000000003441","url":null,"abstract":"People with HIV (PWH) are disproportionately affected by cardiovascular disease (CVD). Psycho-behavioral therapies are capable of targeting the pathophysiology underlying HIV-CVD comorbidity. This study synthesized findings from randomized controlled trials (RCTs) of psycho-behavioral therapies for reducing CVD risk among PWH following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Inclusion criteria were: (1) utilized an RCT design, (2) evaluated a cognitive-behavioral or mindfulness-based therapy, (3) sampled adults (age ≥18 years) with HIV, (4) measured a behavioral (e.g., diet) or biological (e.g., immune functioning) CVD risk factor, and (5) published in an English-language peer-reviewed journal. Electronic searches were conducted in six databases (e.g., MEDLINE) using controlled vocabulary and free-text synonyms for HIV, psycho-behavioral therapy, and CVD risk. Data were independently extracted with consensus reached. Outcomes were immune activation, tobacco-smoking, stress, inflammation, and physical activity from 33 studies. There were stronger effects for psycho-behavioral interventions compared to controls on CD4 (Hedge’s g=0.262, 95% Confidence Interval [CI]=0.127, 0.396) and tobacco-smoking abstinence (Hedge’s g=0.537, 95% CI=0.215, 0.86). There were no differences or insufficient data for stress, inflammation, or physical activity. No eligible studies examined psycho-behavioral interventions on blood pressure, lipids, or weight in PWH. There is increasing importance to further invest in broader CVD risk reduction effort for PWH that include psycho-behavioral intervention strategies.","PeriodicalId":508427,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":" 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140995715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Provocative findings from a transdiagnostic counseling intervention to improve psychiatric comorbidity and HIV care engagement among people with HIV: A Pilot Randomized Clinical Trial","authors":"Brian W. Pence, Doyanne A Darnell, Minu Ranna-Stewart, Christine Psaros, B. Gaynes, LaKendra Grimes, Savannah Henderson, Mariel Parman, Teresa R. Filipowicz, Kathy Gaddis, Shannon Dorsey, M. Mugavero","doi":"10.1097/qai.0000000000003457","DOIUrl":"https://doi.org/10.1097/qai.0000000000003457","url":null,"abstract":"\u0000 \u0000 Depression, anxiety, post-traumatic stress (PTS), and alcohol/substance use disorders are prevalent among people with HIV (PWH), commonly co-occur, and predict worse HIV care outcomes. Transdiagnostic counseling approaches simultaneously address multiple co-occurring mental health disorders.\u0000 \u0000 \u0000 \u0000 We conducted a pilot individually randomized trial of the Common Elements Treatment Approach adapted for people with HIV (CETA-PWH), a transdiagnostic counseling intervention, compared to usual care at a large academic medical center in the southern US. Participants were adults with HIV, at risk for HIV care disengagement, with elevated symptoms of depression, anxiety, PTS, and/or alcohol/substance use. Mental health and HIV care engagement were assessed at four and nine months.\u0000 \u0000 \u0000 \u0000 Among participants (n=60), follow-up was high at four (92%) and nine (85%) months. Intervention engagement was challenging: 93% attended ≥1 session, 43% attended ≥6 sessions in three months (“moderate dose”), and 30% completed treatment. While not powered for effectiveness, mental health outcomes and HIV appointment attendance improved in CETA-PWH relative to usual care in intent-to-treat analyses; those receiving a moderate dose and completers showed progressively greater improvement. Viral load showed small differences between arms. The dose-response pattern was not explained by differences between those who did and did not complete treatment.\u0000 \u0000 \u0000 \u0000 This pilot trial provides preliminary evidence for the potential of CETA-PWH to simultaneously address co-occurring mental health co-morbidities and support HIV appointment attendance among PWH. Additional strategies may be an important part of ensuring that clients can engage in the full course of treatment and realize its full benefits.\u0000","PeriodicalId":508427,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":" 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140994973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tryptophan-Kynurenine Pathway Activation and Cognition in Virally Suppressed Women With HIV","authors":"Ef Shorer, Rm Dastgheyb, Al French, E. Daubert, R. Morack, T. Yohannes, C. Clish, D. Gustafson, A. Sharma, A. Rogando, Q. Qi, H. Burgess, Lh Rubin, Km Weber","doi":"10.1097/qai.0000000000003454","DOIUrl":"https://doi.org/10.1097/qai.0000000000003454","url":null,"abstract":"\u0000 \u0000 Immune and cognitive dysfunction persists even in virally suppressed women with HIV (VS-WWH). Since inflammation and HIV proteins induce the enzyme IDO (indoleamine 2, 3-dioxygenase), converting tryptophan (T) to kynurenine (K) while producing downstream neurotoxic metabolites, we investigated IDO activation (KT ratio) in relation to cognition in VS-WWH and demographically similar women without HIV (WWoH).\u0000 \u0000 \u0000 \u0000 99 VS-WWH on stable antiretroviral therapy and 102 WWoH (median age 52 vs 54 years; 73% vs 74% Black respectively) from the New York and Chicago sites of the Women’s Interagency HIV Study (WIHS) completed a neuropsychological test battery assessing motor function, processing speed, attention/working memory, verbal fluency, verbal learning and memory, and executive function) and had plasma measured for TK metabolites via liquid chromatography-tandem mass spectrometry and monocyte derived (sCD14, sCD163, MCP-1/CCL-2) plus general inflammatory markers (TNF-RII, hsCRP, hsIL-6) via enzyme-linked immunosorbent assays between 2017-20.\u0000 \u0000 \u0000 \u0000 VS-WWH had a higher KT ratio (P<0.01) and higher sCD14 levels (P<0.05) compared to WWoH. Higher sCD163 was associated with higher KT ratio (R=0.29, P <0.01), and worse fine motor function in VS-WWH; after adjusting for sCD163 and sCD14 in multivariable regressions, higher KT ratio remained significantly associated with impaired fine motor function in VS-WWH only (standardized β=-0.29, P<0.05). IDO activation was not associated with cognition in WWoH.\u0000 \u0000 \u0000 \u0000 IDO activation (K:T) was associated with worse fine motor control in VS-WWH independent of measured systemic inflammation. Further studies investigating biological mechanisms linking IDO activation to fine motor function among VS-WWH are warranted.\u0000","PeriodicalId":508427,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":" 18","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140999524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}