A single low dose of hydrocortisone enhances cognitive functioning in HIV-infected women

Leah H. Rubin, K. Luan Phan, Sheila M. Keating, Pauline M. Maki

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: Low-dose hydrocortisone (LDH) enhances aspects of learning and memory in select populations including patients with posttraumatic stress disorder and HIVinfected men. HIV-infected women show impairments in learning and memory, but the cognitive effects of LDH in HIV-infected women are unknown. Design: Double-blind, placebo-controlled, cross-over study examining the timedependent effects of a single low-dose administration of hydrocortisone (10mg oral) on cognition in 36 HIV-infected women. Participants were first randomized to LDH or placebo and then received the opposite treatment one month later. Methods: Cognitive performance was assessed 30 min and 4 h after pill administration to assess, respectively, nongenomic and genomic effects. Self-reported stress/anxiety and salivary cortisol were assessed throughout sessions. Results: LDH significantly increased salivary cortisol levels versus placebo; levels returned to baseline 4-h postadministration. At the 30-min assessment, LDH enhanced verbal learning and delayed memory, working memory, behavioral inhibition, and visuospatial abilities. At the 4-h assessment, LDH enhanced verbal learning and delayed memory compared with placebo. LDH-induced cognitive benefits related to reductions in cytokines and to a lesser extent to increases in cortisol. Conclusion: The extended benefits from 30 min to 4 h of a single administration of LDH on learning and delayed memory suggest that targeting the hypothalamic pituitary adrenal axis may have potential clinical utility in HIV-infected women. These findings contrast with our findings in HIV-infected men who showed improved learning only at the 30-min assessment. Larger, longer term studies are underway to verify possible cognitive enhancing effects of LDH and the clinical significance of these effects in HIV.

Original languageEnglish (US)
Pages (from-to)1983-1993
Number of pages11
JournalAIDS
Volume32
Issue number14
DOIs
StatePublished - 2018
Externally publishedYes

Keywords

  • HIV
  • Hydrocortisone
  • Immune
  • Women
  • cognition

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Infectious Diseases

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