We have located links that may give you full text access.
Altered neuropsychological performance and reduced brain volumetrics in people living with HIV on integrase strand transfer inhibitors.
AIDS 2019 April 17
OBJECTIVES: Neuropsychiatric symptoms have been reported in people living with HIV (PLWH) on integrase strand transfer inhibitors (INSTIs) in post marketing analysis. Limited data exists regarding brain integrity (function and structure) in PLWH prescribed INSTIs compared to other HIV treatment regimens.
DESIGN: A cross-sectional analysis of PLWH on combined antiretroviral therapy (cART) aged >18 years at a single institution.
METHODS: Neuropsychological tests were administered to calculate domain deficit scores (DDS) in learning/memory, executive function, and motor/psychomotor domains. Cortical and subcortical volumes from magnetic resonance imaging were obtained using the FreeSurfer software suite (v5.3) (Harvard University, Boston, MA).
RESULTS: Of 202 participants, median age 55 (48, 60) years old, 49% were on INSTI-based cART. PLWH on INSTIs were similar to individuals on non-INSTIs in terms of age, sex, race, education years, smoking history, depression scores, psychiatric medication use, presence of hepatitis C infection, history of substance use, HIV infection duration and recent or nadir CD4+ T cell count. Participants in the INSTI group performed worse than non-INSTI users in the verbal learning and memory domain (1.25 (interquartile range; 0.25, 2) versus (0.25 (0, 1.8); p = 0.02). The INSTI and non-INSTI groups were similar for other cognitive domains. Frontal, brain stem, and cerebellar volumes were reduced in INSTI compared to non-INSTI users (all p = <0.05).
CONCLUSION: We demonstrated modest differences in learning/memory performance and smaller brain volumes in PLWH on INSTI-based regimens compared to non-INSTI users. Prospective studies are needed to define mechanisms and the clinical significance of reduced brain integrity in PLWH on INSTIs.
DESIGN: A cross-sectional analysis of PLWH on combined antiretroviral therapy (cART) aged >18 years at a single institution.
METHODS: Neuropsychological tests were administered to calculate domain deficit scores (DDS) in learning/memory, executive function, and motor/psychomotor domains. Cortical and subcortical volumes from magnetic resonance imaging were obtained using the FreeSurfer software suite (v5.3) (Harvard University, Boston, MA).
RESULTS: Of 202 participants, median age 55 (48, 60) years old, 49% were on INSTI-based cART. PLWH on INSTIs were similar to individuals on non-INSTIs in terms of age, sex, race, education years, smoking history, depression scores, psychiatric medication use, presence of hepatitis C infection, history of substance use, HIV infection duration and recent or nadir CD4+ T cell count. Participants in the INSTI group performed worse than non-INSTI users in the verbal learning and memory domain (1.25 (interquartile range; 0.25, 2) versus (0.25 (0, 1.8); p = 0.02). The INSTI and non-INSTI groups were similar for other cognitive domains. Frontal, brain stem, and cerebellar volumes were reduced in INSTI compared to non-INSTI users (all p = <0.05).
CONCLUSION: We demonstrated modest differences in learning/memory performance and smaller brain volumes in PLWH on INSTI-based regimens compared to non-INSTI users. Prospective studies are needed to define mechanisms and the clinical significance of reduced brain integrity in PLWH on INSTIs.
Full text links
Trending Papers
A Personalized Approach to the Management of Congestion in Acute Heart Failure.Heart International 2023
Potential Mechanisms of the Protective Effects of the Cardiometabolic Drugs Type-2 Sodium-Glucose Transporter Inhibitors and Glucagon-like Peptide-1 Receptor Agonists in Heart Failure.International Journal of Molecular Sciences 2024 Februrary 21
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app
All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.
By using this service, you agree to our terms of use and privacy policy.
Your Privacy Choices
You can now claim free CME credits for this literature searchClaim now
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app