TY - JOUR
T1 - Cognitive function in women with HIV
T2 - Findings from the women's interagency HIV study
AU - Maki, Pauline M.
AU - Rubin, Leah H.
AU - Valcour, Victor
AU - Martin, Eileen
AU - Crystal, Howard
AU - Young, Mary
AU - Weber, Kathleen M.
AU - Manly, Jennifer
AU - Richardson, Jean
AU - Alden, Christine
AU - Anastos, Kathryn
N1 - Publisher Copyright:
© 2014 American Academy of Neurology.
PY - 2015
Y1 - 2015
N2 - Objective: In the largest cohort study of neuropsychological outcomes among HIV-infected women to date, we examined the association between HIV status and cognition in relation to other determinants of cognitive function (aim 1) and the pattern and magnitude of impairment across cognitive outcomes (aim 2). Methods: From 2009 to 2011, 1,521 (1,019 HIV-infected) participants from theWomen's Interagency HIV Study (WIHS) completed a comprehensive neuropsychological test battery. We used multivariable regression on raw test scores for the first aim and normative regression-based analyses (t scores) for the second aim. The design was cross-sectional. Results: The effect sizes for HIV status on cognition were very small, accounting for only 0.05 to 0.09 SD units. The effect of HIV status was smaller than that of years of education, age, race, income, and reading level. In adjusted analyses, HIV-infected women performed worse than uninfected women on verbal learning, delayed recall and recognition, and psychomotor speed and attention. The largest deficit was observed in delayed memory. The association of low reading level with cognition was greater in HIV-infected compared to HIV-uninfected women. HIV biomarkers (CD4 count, history of AIDS-defining illness, viral load) were associated with cognitive dysfunction. Conclusions: The effect of HIV on cognition in women is very small except among women with low reading level or HIV-related comorbidities. Direct comparisons of rates of impairment in wellmatched groups of HIV-infected men and women are needed to evaluate possible sex differences in cognition.
AB - Objective: In the largest cohort study of neuropsychological outcomes among HIV-infected women to date, we examined the association between HIV status and cognition in relation to other determinants of cognitive function (aim 1) and the pattern and magnitude of impairment across cognitive outcomes (aim 2). Methods: From 2009 to 2011, 1,521 (1,019 HIV-infected) participants from theWomen's Interagency HIV Study (WIHS) completed a comprehensive neuropsychological test battery. We used multivariable regression on raw test scores for the first aim and normative regression-based analyses (t scores) for the second aim. The design was cross-sectional. Results: The effect sizes for HIV status on cognition were very small, accounting for only 0.05 to 0.09 SD units. The effect of HIV status was smaller than that of years of education, age, race, income, and reading level. In adjusted analyses, HIV-infected women performed worse than uninfected women on verbal learning, delayed recall and recognition, and psychomotor speed and attention. The largest deficit was observed in delayed memory. The association of low reading level with cognition was greater in HIV-infected compared to HIV-uninfected women. HIV biomarkers (CD4 count, history of AIDS-defining illness, viral load) were associated with cognitive dysfunction. Conclusions: The effect of HIV on cognition in women is very small except among women with low reading level or HIV-related comorbidities. Direct comparisons of rates of impairment in wellmatched groups of HIV-infected men and women are needed to evaluate possible sex differences in cognition.
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U2 - 10.1212/WNL.0000000000001151
DO - 10.1212/WNL.0000000000001151
M3 - Article
C2 - 25540304
AN - SCOPUS:84925934730
SN - 0028-3878
VL - 84
SP - 231
EP - 240
JO - Neurology
JF - Neurology
IS - 3
ER -