Neurocognitive Trajectories After 72 Weeks of First-Line Anti-retroviral Therapy in Vietnamese Adults With HIV-HCV Co-infection.

Autor:	Paul RH; University of Missouri-St. Louis, St. Louis, MO, United States., Shikuma CM; Hawai'i Center for AIDS, University of Hawai'i at Manoa, Honolulu, HI, United States., Chau NVV; Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam., Ndhlovu LC; Hawai'i Center for AIDS, University of Hawai'i at Manoa, Honolulu, HI, United States.; Cornell University School of Medicine, New York City, NY, United States., Thanh NT; Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam., Belden AC; University of Missouri-St. Louis, St. Louis, MO, United States., Chow DC; Hawai'i Center for AIDS, University of Hawai'i at Manoa, Honolulu, HI, United States., Chew GM; Hawai'i Center for AIDS, University of Hawai'i at Manoa, Honolulu, HI, United States., Premeaux TA; Hawai'i Center for AIDS, University of Hawai'i at Manoa, Honolulu, HI, United States.; Cornell University School of Medicine, New York City, NY, United States., Ly VT; Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam.; University of Medicine and Pharmacy at Ho Chi Minh City, Vietnam., McBride JAD; University of Missouri-St. Louis, St. Louis, MO, United States., Bolzenius JD; University of Missouri-St. Louis, St. Louis, MO, United States., Le T; Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam.; Duke University School of Medicine, Durham, NC, United States.
Jazyk:	angličtina
Zdroj:	Frontiers in neurology [Front Neurol] 2021 Mar 12; Vol. 12, pp. 602263. Date of Electronic Publication: 2021 Mar 12 (Print Publication: 2021).
DOI:	10.3389/fneur.2021.602263
Abstrakt:	Background: Long-term neurocognitive outcomes following first-line suppressive anti-retroviral therapy (ART) remain uncertain for individuals with HIV and hepatitis C (HCV) co-infection. The study examined neurocognitive performance before and after 72 weeks of ART using repeated multivariate analyses and latent trajectory models. Methods: One hundred and sixty adults with chronic, untreated HIV infection ( n = 80 with HCV co-infection and n = 80 HIV mono-infected) and 80 demographically similar healthy controls were recruited from the Hospital for Tropical Diseases in Ho Chi Minh City and the surrounding community, respectively. Neurocognitive measures (adapted for use in Vietnam) and liver enzyme tests were compared across groups at baseline. Repeated multivariate and group-based trajectory analyses (GBTA) examined neurocognitive subgroup profiles of the co-infected individuals after 72 weeks of de novo efavirenz- ( n = 41) or raltegravir-based ( n = 39) ART. Results: Baseline analyses revealed worse motor function in HIV-HCV co-infected individuals compared to both comparison groups. Longitudinal analyses revealed improved neurocognitive performance by week 48 for most participants regardless of treatment arm. GBTA identified a subgroup (35% of HIV-HCV sample) with persistent motor impairment despite otherwise successful ART. Higher HIV viral load and lower CD4 + T cell count at baseline predicted persistent motor dysfunction. Liver indices and ART regimen did not predict neurocognitive outcomes in HIV-HCV co-infected individuals. Conclusions: Most HIV-HCV co-infected individuals achieve normative neurocognitive performance after 48 weeks of de novo suppressive ART. However, individuals with more severe HIV disease prior to ART exhibited motor impairment at baseline and 72 weeks after otherwise successful treatment. Interventions aimed at improving motor symptoms at the time of HIV treatment onset may improve long-term clinical outcomes in HIV-HCV co-infected adults. Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (Copyright © 2021 Paul, Shikuma, Chau, Ndhlovu, Thanh, Belden, Chow, Chew, Premeaux, Ly, McBride, Bolzenius and Le.)
Databáze:	MEDLINE
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