Neurocognitive impact of substance use in HIV infection.

TitleNeurocognitive impact of substance use in HIV infection.
Publication TypeJournal Article
Year of Publication2011
AuthorsByrd, DA, Fellows, RP, Morgello, S, Franklin, D, Heaton, RK, Deutsch, R, J Atkinson, H, Clifford, DB, Collier, AC, Marra, CM, Gelman, B, J McCutchan, A, Duarte, NA, Simpson, DM, McArthur, J, Grant, I
Corporate AuthorsCHARTER Group
JournalJ Acquir Immune Defic Syndr
Date Published2011 Oct 01
KeywordsAdult, CHARTER, Cognition Disorders, Female, HIV Infections, Humans, Internal, Male, Middle Aged, Neuropsychological Tests, Severity of Illness Index, Substance-Related Disorders, Time Factors

BACKGROUND: : To determine how serious a confound substance use (SU) might be in studies on HIV-associated neurocognitive disorder (HAND), we examined the relationship of SU history to neurocognitive impairment (NCI) in participants enrolled in the Central Nervous System HIV Antiretroviral Therapy Effects Research study.METHODS: : After excluding cases with behavioral evidence of acute intoxication and histories of factors that independently could account for NCI (eg, stroke), baseline demographic, medical, SU, and neurocognitive data were analyzed from 399 participants. Potential SU risk for NCI was determined by the following criteria: lifetime SU Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition diagnosis, self-report of marked lifetime SU, or positive urine toxicology. Participants were divided into 3 groups as follows: no SU (n = 134), nonsyndromic SU (n = 131), syndromic SU (n = 134) and matched on literacy level, nadir CD4, and depressive symptoms.RESULTS: : Although approximately 50% of the participants were diagnosed with HAND, a multivariate analysis of covariance of neurocogntive summary scores, covarying for urine toxicology, revealed no significant effect of SU status. Correlational analyses indicated weak associations between lifetime heroin dosage and poor recall and working memory and between cannabis and cocaine use and better verbal fluency.CONCLUSIONS: : These data indicate that HIV neurocognitive effects are seen at about the same frequency in those with and without historic substance abuse in cases that are equated on other factors that might contribute to NCI. Therefore, studies on neuroAIDS and its treatment need not exclude such cases. However, the effects of acute SU and current SU disorders on HAND require further study.

Alternate JournalJ. Acquir. Immune Defic. Syndr.
PubMed ID21725250
PubMed Central IDPMC3183737
Grant ListR24 MH059724 / MH / NIMH NIH HHS / United States
M01 RR 00071 / RR / NCRR NIH HHS / United States
R24MH59724 / MH / NIMH NIH HHS / United States
HHSN271201000036C / MH / NIMH NIH HHS / United States
M01 RR000071 / RR / NCRR NIH HHS / United States
U01MH083501 / MH / NIMH NIH HHS / United States
U01 MH083501 / MH / NIMH NIH HHS / United States
N01 MH022005 / MH / NIMH NIH HHS / United States