Jason S DeFelice, Mark K Britton, Yancheng Li, Eric C Porges, Gladys E Ibañez, Charurut Somboonwit, Robert L Cook, Ronald A Cohen, Joseph M Gullett
{"title":"自HIV诊断以来的时间与老年HIV感染者的遗忘性轻度认知障碍(MCI)有关。","authors":"Jason S DeFelice, Mark K Britton, Yancheng Li, Eric C Porges, Gladys E Ibañez, Charurut Somboonwit, Robert L Cook, Ronald A Cohen, Joseph M Gullett","doi":"10.1007/s13365-025-01271-w","DOIUrl":null,"url":null,"abstract":"<p><p>Aging people with HIV (PWH) may be at heightened risk of Mild Cognitive Impairment (MCI), including the subtypes amnestic MCI (aMCI) and non-amnestic MCI (naMCI). We examined associations between putative risk factors (HIV clinical variables, lifetime substance exposure, APOE genotype) and clinician consensus-defined MCI status in older PWH. Additionally, we evaluated agreement between clinician consensus aMCI and algorithmic (Jak-Bondi) aMCI classification, as well as overlap between aMCI and HIV-Associated Neurocognitive Disorder (HAND). PWH (N = 56; median age 63; IQR 61-67) completed a neurocognitive battery. Two neuropsychologists assigned consensus diagnoses (aMCI/naMCI/no MCI). Alcohol, cocaine, opioid, and cannabis exposure, years since HIV diagnosis, and time from diagnosis to care were assessed by self-report. APOE was genotyped from whole blood. HIV viral load (detectable/undetectable) was assayed from plasma. Algorithmic aMCI classification was made using modified Jak-Bondi criteria and HAND classification using Frascati criteria. 36% of participants (N = 20) met consensus aMCI criteria. aMCI status was significantly associated with years since HIV diagnosis, time to care, and opioid exposure in age-adjusted models. However, MCI status was not associated with alcohol, cocaine, or cannabis exposure, APOE genotype, or detectable viral load. Agreement between clinician consensus and algorithmic aMCI classification was substantial. Participants with aMCI and naMCI (vs. no MCI) were significantly more likely to meet HAND criteria. Because time since diagnosis and time from diagnosis to care were associated with amnestic MCI in PWH, greater cumulative HIV exposure may be linked to greater neuropathology in aging.</p>","PeriodicalId":16665,"journal":{"name":"Journal of NeuroVirology","volume":" ","pages":""},"PeriodicalIF":1.9000,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Time since HIV diagnosis is linked to amnestic mild cognitive impairment (MCI) in older adults with HIV.\",\"authors\":\"Jason S DeFelice, Mark K Britton, Yancheng Li, Eric C Porges, Gladys E Ibañez, Charurut Somboonwit, Robert L Cook, Ronald A Cohen, Joseph M Gullett\",\"doi\":\"10.1007/s13365-025-01271-w\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Aging people with HIV (PWH) may be at heightened risk of Mild Cognitive Impairment (MCI), including the subtypes amnestic MCI (aMCI) and non-amnestic MCI (naMCI). We examined associations between putative risk factors (HIV clinical variables, lifetime substance exposure, APOE genotype) and clinician consensus-defined MCI status in older PWH. Additionally, we evaluated agreement between clinician consensus aMCI and algorithmic (Jak-Bondi) aMCI classification, as well as overlap between aMCI and HIV-Associated Neurocognitive Disorder (HAND). PWH (N = 56; median age 63; IQR 61-67) completed a neurocognitive battery. Two neuropsychologists assigned consensus diagnoses (aMCI/naMCI/no MCI). Alcohol, cocaine, opioid, and cannabis exposure, years since HIV diagnosis, and time from diagnosis to care were assessed by self-report. APOE was genotyped from whole blood. HIV viral load (detectable/undetectable) was assayed from plasma. Algorithmic aMCI classification was made using modified Jak-Bondi criteria and HAND classification using Frascati criteria. 36% of participants (N = 20) met consensus aMCI criteria. aMCI status was significantly associated with years since HIV diagnosis, time to care, and opioid exposure in age-adjusted models. However, MCI status was not associated with alcohol, cocaine, or cannabis exposure, APOE genotype, or detectable viral load. Agreement between clinician consensus and algorithmic aMCI classification was substantial. Participants with aMCI and naMCI (vs. no MCI) were significantly more likely to meet HAND criteria. Because time since diagnosis and time from diagnosis to care were associated with amnestic MCI in PWH, greater cumulative HIV exposure may be linked to greater neuropathology in aging.</p>\",\"PeriodicalId\":16665,\"journal\":{\"name\":\"Journal of NeuroVirology\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":1.9000,\"publicationDate\":\"2025-07-18\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of NeuroVirology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s13365-025-01271-w\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"NEUROSCIENCES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of NeuroVirology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s13365-025-01271-w","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"NEUROSCIENCES","Score":null,"Total":0}
Time since HIV diagnosis is linked to amnestic mild cognitive impairment (MCI) in older adults with HIV.
Aging people with HIV (PWH) may be at heightened risk of Mild Cognitive Impairment (MCI), including the subtypes amnestic MCI (aMCI) and non-amnestic MCI (naMCI). We examined associations between putative risk factors (HIV clinical variables, lifetime substance exposure, APOE genotype) and clinician consensus-defined MCI status in older PWH. Additionally, we evaluated agreement between clinician consensus aMCI and algorithmic (Jak-Bondi) aMCI classification, as well as overlap between aMCI and HIV-Associated Neurocognitive Disorder (HAND). PWH (N = 56; median age 63; IQR 61-67) completed a neurocognitive battery. Two neuropsychologists assigned consensus diagnoses (aMCI/naMCI/no MCI). Alcohol, cocaine, opioid, and cannabis exposure, years since HIV diagnosis, and time from diagnosis to care were assessed by self-report. APOE was genotyped from whole blood. HIV viral load (detectable/undetectable) was assayed from plasma. Algorithmic aMCI classification was made using modified Jak-Bondi criteria and HAND classification using Frascati criteria. 36% of participants (N = 20) met consensus aMCI criteria. aMCI status was significantly associated with years since HIV diagnosis, time to care, and opioid exposure in age-adjusted models. However, MCI status was not associated with alcohol, cocaine, or cannabis exposure, APOE genotype, or detectable viral load. Agreement between clinician consensus and algorithmic aMCI classification was substantial. Participants with aMCI and naMCI (vs. no MCI) were significantly more likely to meet HAND criteria. Because time since diagnosis and time from diagnosis to care were associated with amnestic MCI in PWH, greater cumulative HIV exposure may be linked to greater neuropathology in aging.
期刊介绍:
The Journal of NeuroVirology (JNV) provides a unique platform for the publication of high-quality basic science and clinical studies on the molecular biology and pathogenesis of viral infections of the nervous system, and for reporting on the development of novel therapeutic strategies using neurotropic viral vectors. The Journal also emphasizes publication of non-viral infections that affect the central nervous system. The Journal publishes original research articles, reviews, case reports, coverage of various scientific meetings, along with supplements and special issues on selected subjects.
The Journal is currently accepting submissions of original work from the following basic and clinical research areas: Aging & Neurodegeneration, Apoptosis, CNS Signal Transduction, Emerging CNS Infections, Molecular Virology, Neural-Immune Interaction, Novel Diagnostics, Novel Therapeutics, Stem Cell Biology, Transmissable Encephalopathies/Prion, Vaccine Development, Viral Genomics, Viral Neurooncology, Viral Neurochemistry, Viral Neuroimmunology, Viral Neuropharmacology.