Coagulation imbalance and neurocognitive functioning in older HIV-positive adults on suppressive antiretroviral therapy
| Autor: | Montoya, JL, Iudicello, J, Oppenheim, HA, Fazeli, PL, Potter, M, Ma, Q, Mills, PJ, Ellis, RJ, Grant, I, Letendre, SL, Moore, DJ, Gr, HIVNRPHNRP |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
cognition Sustained Virologic Response Neurocognitive Disorders HIV Infections Medical and Health Sciences endothelial dysfunction coagulopathy Clinical Research Virology Humans Prevention Psychology and Cognitive Sciences Neurosciences virus diseases Evaluation of treatments and therapeutic interventions Hematology Blood Coagulation Disorders Biological Sciences Cross-Sectional Studies Infectious Diseases Good Health and Well Being Anti-Retroviral Agents ageing inflammation 6.1 Pharmaceuticals haemostasis HIV/AIDS HIV Neurobehavioral Research Program (HNRP) Group Infection |
| Zdroj: | AIDS (London, England), vol 31, iss 6 Montoya, JL; Iudicello, J; Oppenheim, HA; Fazeli, PL; Potter, M; Ma, Q; et al.(2017). Coagulation imbalance and neurocognitive functioning in older HIV-positive adults on suppressive antiretroviral therapy. AIDS, 31(6), 787-795. doi: 10.1097/QAD.0000000000001404. UC San Diego: Retrieved from: http://www.escholarship.org/uc/item/6z64v1df |
| DOI: | 10.1097/QAD.0000000000001404. |
| Popis: | ObjectivesThe aim of this study was to compare plasma biomarkers of coagulation between HIV-infected individuals and HIV-uninfected controls and to assess the impact of disturbances in coagulation on neurocognitive functioning in HIV.DesignA cross-sectional study of 66 antiretroviral therapy treated, virally suppressed, HIV-infected and 34 HIV-uninfected older (≥50 years of age) adults.MethodsParticipants completed standardized neurobehavioral and neuromedical assessments. Neurocognitive functioning was evaluated using a well validated comprehensive neuropsychological battery. Plasma biomarkers associated with procoagulation (fibrinogen, p-selectin, tissue factor and von Willebrand factor), anticoagulation (antithrombin, protein C and thrombomodulin), fibrinolysis (d-dimer, plasminogen activator inhibitor-1 and plasminogen) were collected. Multivariable linear regression was used to test the interaction of HIV and coagulation on neurocognitive functioning.ResultsMost participants were male (78.0%) and non-Hispanic white (73.0%) with a mean age of 57.8 years. Among HIV-infected participants, mean estimated duration of HIV infection was 19.4 years and median current CD4 cell count was 654 cells/μl. Levels of soluble biomarkers of procoagulation, anticoagulation and fibrinolysis were comparable between the HIV serostatus groups. Coagulation and HIV had an interacting effect on neurocognitive functioning, such that greater coagulation imbalance was associated with poorer neurocognitive functioning among the HIV-infected participants. The moderating effect of coagulation on neurocognition was driven by procoagulant but not anticoagulant or fibrinolytic biomarkers.ConclusionsElevated levels of procoagulants may exert a particularly detrimental effect on neurocognitive functioning among older HIV-infected persons. A better understanding of the specific role of coagulation in the cause of HIV-associated neurocognitive disorders may lead to treatments aimed at reducing coagulopathy, thereby improving neurocognitive outcomes. |
| Databáze: | OpenAIRE |
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