Anemia and Erythrocyte Indices Are Associated With Neurocognitive Performance Across Multiple Ability Domains in Adults With HIV.

Autor:	Okwuegbuna OK; Department of Medicine, University of California, San Diego, CA., Kaur H; Department of Genomic Medicine, Lerner Research Institute, Cleveland Clinic., Jennifer I; Department of Neuroscience, University of California, San Diego, CA., Bush WS; Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, OH., Bharti A; Department of Medicine, University of California, San Diego, CA., Umlauf A; Department of Psychiatry, University of California, San Diego, CA; and., Ellis RJ; Department of Neuroscience, University of California, San Diego, CA.; Department of Psychiatry, University of California, San Diego, CA; and., Franklin DR; Department of Psychiatry, University of California, San Diego, CA; and., Heaton RK; Department of Psychiatry, University of California, San Diego, CA; and., McCutchan JA; Department of Medicine, University of California, San Diego, CA., Kallianpur AR; Department of Genomic Medicine, Lerner Research Institute, Cleveland Clinic.; Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, OH.; Department of Molecular Medicine, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH., Letendre SL; Department of Medicine, University of California, San Diego, CA.; Department of Psychiatry, University of California, San Diego, CA; and.
Jazyk:	angličtina
Zdroj:	Journal of acquired immune deficiency syndromes (1999) [J Acquir Immune Defic Syndr] 2023 Apr 15; Vol. 92 (5), pp. 414-421.
DOI:	10.1097/QAI.0000000000003155
Abstrakt:	Background: Anemia is linked to neurocognitive impairment (NCI) in people with HIV (PWH), but its impact within specific ability domains, and in diverse populations with HIV, is uncertain. Methods: Participants included 1339 PWH enrolled in observational HIV cohort studies with a mean of 3 comprehensive neurocognitive assessments over 30 months. Global and domain-specific neurocognitive function were assessed by the global deficit score and domain deficit score (GDS and DDS, respectively) or as GDS-defined or DDS-defined NCI (GDS ≥ 0.5, DDS > 0.5). Time-dependent associations of anemia or red-cell indices with neurocognitive function were evaluated by multivariable regression. Results: The mean age at entry was 43.6 years (85% male, 23.9% Hispanic, 16.7% African ancestry by self-report, and 69.8% virally suppressed). Anemia occurred at entry in 297 (22.2%) and developed subsequently in another 129 (9.6%). Anemia (present in 26.8% of cognitively impaired PWH at entry) and lower hemoglobin were associated with higher (worse) GDS values; the association for anemia persisted after multivariable adjustment and in virally suppressed persons ( P < 0.0001). Anemia was also associated with reduced processing speed, motor function, learning, delayed recall, working memory (all P < 0.01), executive function ( P = 0.021), and verbal fluency ( P = 0.035), and these findings persisted in longitudinal analyses (adjusted P < 0.01 for all domains, except verbal fluency). Higher mean corpuscular volume and mean corpuscular hemoglobin were associated with less impairment in learning and recall (all P < 0.05). Conclusions: Anemia in diverse and virally suppressed PWH associates with reduced neurocognitive performance in multiple domains, cross-sectionally and over time. The impact of identifying and treating anemia to prevent or slow neurocognitive decline in PWH should be prospectively evaluated. Competing Interests: The authors have no conflicts of interest to disclose. (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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