TY - JOUR
T1 - Anemia and red blood cell indices predict HIV-associated neurocognitive impairment in the highly active antiretroviral therapy era
AU - Kallianpur, Asha R.
AU - Wang, Quan
AU - Jia, Peilin
AU - Hulgan, Todd
AU - Zhao, Zhongming
AU - Letendre, Scott L.
AU - Ellis, Ronald J.
AU - Heaton, Robert K.
AU - Franklin, Donald R.
AU - Barnholtz-Sloan, Jill
AU - Collier, Ann C.
AU - Marra, Christina M.
AU - Clifford, David B.
AU - Gelman, Benjamin B.
AU - McArthur, Justin C.
AU - Morgello, Susan
AU - Simpson, David M.
AU - McCutchan, J. A.
AU - Grant, Igor
AU - McCutchan, J. Allen
AU - Marcotte, Thomas D.
AU - Franklin, Donald
AU - Alexander, Terry
AU - Capparelli, Edmund
AU - Atkinson, J. Hampton
AU - Woods, Steven Paul
AU - Dawson, Matthew
AU - Smith, David M.
AU - Fennema-Notestine, Christine
AU - Taylor, Michael J.
AU - Theilmann, Rebecca
AU - Gamst, Anthony C.
AU - Cushman, Clint
AU - Abramson, Ian
AU - Vaida, Florin
AU - Marquie-Beck, Jennifer
AU - Rogalski, Vincent
AU - Simpson, David
AU - Mintz, Letty
AU - Toperoff, Will
AU - Collier, Ann
AU - Marra, Christina
AU - Jones, Trudy
AU - Gelman, Benjamin
AU - Head, Eleanor
AU - Al-Lozi, Muhammad
AU - Teshome, Mengesha
N1 - Publisher Copyright:
© The Author 2015.
PY - 2016/4/1
Y1 - 2016/4/1
N2 - Background. Anemia has been linked to adverse human immunodeficiency virus (HIV) outcomes, including dementia, in the era before highly active antiretroviral therapy (HAART). Milder forms of HIV-associated neurocognitive disorder (HAND) remain common in HIV-infected persons, despite HAART, but whether anemia predicts HAND in the HAART era is unknown. Methods. We evaluated time-dependent associations of anemia and cross-sectional associations of red blood cell indices with neurocognitive impairment in a multicenter, HAART-era HIV cohort study (N = 1261), adjusting for potential confounders, including age, nadir CD4+ T-cell count, zidovudine use, and comorbid conditions. Subjects underwent comprehensive neuropsychiatric and neuromedical assessments. Results. HAND, defined according to standardized criteria, occurred in 595 subjects (47%) at entry. Mean corpuscular volume and mean corpuscular hemoglobin were positively associated with the global deficit score, a continuous measure of neurocognitive impairment (both P < .01), as well as with all HAND, milder forms of HAND, and HIV-associated dementia in multivariable analyses (all P < .05). Anemia independently predicted development of HAND during a median follow-up of 72 months (adjusted hazard ratio, 1.55; P < .01). Conclusions. Anemia and red blood cell indices predict HAND in the HAART era and may contribute to risk assessment. Future studies should address whether treating anemia may help to prevent HAND or improve cognitive function in HIV-infected persons.
AB - Background. Anemia has been linked to adverse human immunodeficiency virus (HIV) outcomes, including dementia, in the era before highly active antiretroviral therapy (HAART). Milder forms of HIV-associated neurocognitive disorder (HAND) remain common in HIV-infected persons, despite HAART, but whether anemia predicts HAND in the HAART era is unknown. Methods. We evaluated time-dependent associations of anemia and cross-sectional associations of red blood cell indices with neurocognitive impairment in a multicenter, HAART-era HIV cohort study (N = 1261), adjusting for potential confounders, including age, nadir CD4+ T-cell count, zidovudine use, and comorbid conditions. Subjects underwent comprehensive neuropsychiatric and neuromedical assessments. Results. HAND, defined according to standardized criteria, occurred in 595 subjects (47%) at entry. Mean corpuscular volume and mean corpuscular hemoglobin were positively associated with the global deficit score, a continuous measure of neurocognitive impairment (both P < .01), as well as with all HAND, milder forms of HAND, and HIV-associated dementia in multivariable analyses (all P < .05). Anemia independently predicted development of HAND during a median follow-up of 72 months (adjusted hazard ratio, 1.55; P < .01). Conclusions. Anemia and red blood cell indices predict HAND in the HAART era and may contribute to risk assessment. Future studies should address whether treating anemia may help to prevent HAND or improve cognitive function in HIV-infected persons.
KW - Anemia
KW - HIV-associated neurocognitive disorder
KW - Human immunodeficiency virus (HIV)
KW - Iron metabolism
KW - Mitochondrial dysfunction
KW - Neurocognitive impairment
KW - Red blood cell indices
UR - http://www.scopus.com/inward/record.url?scp=84962528745&partnerID=8YFLogxK
U2 - 10.1093/infdis/jiv754
DO - 10.1093/infdis/jiv754
M3 - Article
C2 - 26690344
AN - SCOPUS:84962528745
SN - 0022-1899
VL - 213
SP - 1065
EP - 1073
JO - Journal of Infectious Diseases
JF - Journal of Infectious Diseases
IS - 7
ER -