Cargando…
Liver fibrosis is associated with cognitive impairment in HIV-positive patients
INTRODUCTION: The aim of our study was to investigate the potential relationship between liver fibrosis (LF) and cognitive performance in HIV+ patients. MATERIALS AND METHODS: We performed a cross-sectional cohort study by consecutively enrolling HIV+ patients during routine outpatient visits at two...
Autores principales: | , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
International AIDS Society
2014
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4225249/ https://www.ncbi.nlm.nih.gov/pubmed/25397468 http://dx.doi.org/10.7448/IAS.17.4.19722 |
_version_ | 1782343470552186880 |
---|---|
author | Ciccarelli, Nicoletta Fabbiani, Massimiliano Grima, Pierfrancesco Limiti, Silio Fanti, Iuri Mondi, Annalisa Gagliardini, Roberta D'Avino, Alessandro Borghetti, Alberto Cauda, Roberto Di Giambenedetto, Simona |
author_facet | Ciccarelli, Nicoletta Fabbiani, Massimiliano Grima, Pierfrancesco Limiti, Silio Fanti, Iuri Mondi, Annalisa Gagliardini, Roberta D'Avino, Alessandro Borghetti, Alberto Cauda, Roberto Di Giambenedetto, Simona |
author_sort | Ciccarelli, Nicoletta |
collection | PubMed |
description | INTRODUCTION: The aim of our study was to investigate the potential relationship between liver fibrosis (LF) and cognitive performance in HIV+ patients. MATERIALS AND METHODS: We performed a cross-sectional cohort study by consecutively enrolling HIV+ patients during routine outpatient visits at two clinical centres in Italy. Subjects with decompensated liver disease were excluded. All subjects underwent a comprehensive neuropsychological battery exploring memory, attention, psychomotor speed and language; cognitive impairment was defined as at least two abnormal [1.5 SD below the mean for appropriate norms] cognitive domains. LF was explored by calculating FIB4 index; in a subgroup of patients, LF was also assessed by transient elastography. Factors associated with cognitive impairment were investigated by logistic regression models. RESULTS: A total of 413 patients [77% males, median age 46 (IQR 39–52), 17% with past AIDS-defining events, 19% past IDU, 3% with diabetes, 94% on cART, 90% with HIV RNA <50 copies/mL, 18% co-infected with HCV] were enrolled. Seventeen patients (4%) had FIB4 >3.25 and 14/129 (3%) had liver stiffness >14KPa. Forty-seven patients (11%) were diagnosed with cognitive impairment. At multivariate analyses patients with FIB4 >1.45 showed a higher risk of cognitive impairment in comparison with those with lower values (OR 2.19, 95% CI 1.02–4.72; p=0.044) after adjusting for education (OR 0.79, 95% CI 0.71–0.88; p<0.001), past IDU (OR 1.69, 95% CI 0.67–4.23; p=0.264), diabetes (OR 2.35, 95% CI 0.62–8.86; p=0.207), HIV RNA <50 copies/mL (OR 0.47, 95% CI 0.19–1.14; p=0.095) and HCV co-infection (OR 0.88, 95% CI 0.33–2.39; p=0.807). Analyzing any single cognitive domain, a higher risk of abnormal psychomotor speed was associated with fibroscan score >14KPa in comparison with fibroscan score <7KPa (OR 285.07; 95% CI 2.42–33574.06; p=0.020) after adjusting for education (OR 0.54, 95% CI 0.31–0.92; p=0.024), age (for 10 years increase) (OR 2.03, 95% CI 0.55–7.53; p=0.288), past IDU (OR 4.43, 95% CI 0.35–7.57; p=0.526), HIV RNA <50 copies/mL (OR 0.01, 95% CI 0.00–0.18; p=0.003), HIV history (for 1 year increase) (OR 0.96, 95% CI 0.83–1.12; p=0.641), CD4 cells count at nadir (OR 1.10, 95% CI 0.56–2.16; p=0.779), and HCV co-infection (OR 0.06; 95% CI 0.00–1.93; p=0.113). CONCLUSIONS: In HIV-infected patients higher LF, estimated through non-invasive methods, is associated to a higher risk of cognitive impairment. |
format | Online Article Text |
id | pubmed-4225249 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | International AIDS Society |
record_format | MEDLINE/PubMed |
spelling | pubmed-42252492014-11-12 Liver fibrosis is associated with cognitive impairment in HIV-positive patients Ciccarelli, Nicoletta Fabbiani, Massimiliano Grima, Pierfrancesco Limiti, Silio Fanti, Iuri Mondi, Annalisa Gagliardini, Roberta D'Avino, Alessandro Borghetti, Alberto Cauda, Roberto Di Giambenedetto, Simona J Int AIDS Soc Poster Sessions – Abstract P190 INTRODUCTION: The aim of our study was to investigate the potential relationship between liver fibrosis (LF) and cognitive performance in HIV+ patients. MATERIALS AND METHODS: We performed a cross-sectional cohort study by consecutively enrolling HIV+ patients during routine outpatient visits at two clinical centres in Italy. Subjects with decompensated liver disease were excluded. All subjects underwent a comprehensive neuropsychological battery exploring memory, attention, psychomotor speed and language; cognitive impairment was defined as at least two abnormal [1.5 SD below the mean for appropriate norms] cognitive domains. LF was explored by calculating FIB4 index; in a subgroup of patients, LF was also assessed by transient elastography. Factors associated with cognitive impairment were investigated by logistic regression models. RESULTS: A total of 413 patients [77% males, median age 46 (IQR 39–52), 17% with past AIDS-defining events, 19% past IDU, 3% with diabetes, 94% on cART, 90% with HIV RNA <50 copies/mL, 18% co-infected with HCV] were enrolled. Seventeen patients (4%) had FIB4 >3.25 and 14/129 (3%) had liver stiffness >14KPa. Forty-seven patients (11%) were diagnosed with cognitive impairment. At multivariate analyses patients with FIB4 >1.45 showed a higher risk of cognitive impairment in comparison with those with lower values (OR 2.19, 95% CI 1.02–4.72; p=0.044) after adjusting for education (OR 0.79, 95% CI 0.71–0.88; p<0.001), past IDU (OR 1.69, 95% CI 0.67–4.23; p=0.264), diabetes (OR 2.35, 95% CI 0.62–8.86; p=0.207), HIV RNA <50 copies/mL (OR 0.47, 95% CI 0.19–1.14; p=0.095) and HCV co-infection (OR 0.88, 95% CI 0.33–2.39; p=0.807). Analyzing any single cognitive domain, a higher risk of abnormal psychomotor speed was associated with fibroscan score >14KPa in comparison with fibroscan score <7KPa (OR 285.07; 95% CI 2.42–33574.06; p=0.020) after adjusting for education (OR 0.54, 95% CI 0.31–0.92; p=0.024), age (for 10 years increase) (OR 2.03, 95% CI 0.55–7.53; p=0.288), past IDU (OR 4.43, 95% CI 0.35–7.57; p=0.526), HIV RNA <50 copies/mL (OR 0.01, 95% CI 0.00–0.18; p=0.003), HIV history (for 1 year increase) (OR 0.96, 95% CI 0.83–1.12; p=0.641), CD4 cells count at nadir (OR 1.10, 95% CI 0.56–2.16; p=0.779), and HCV co-infection (OR 0.06; 95% CI 0.00–1.93; p=0.113). CONCLUSIONS: In HIV-infected patients higher LF, estimated through non-invasive methods, is associated to a higher risk of cognitive impairment. International AIDS Society 2014-11-02 /pmc/articles/PMC4225249/ /pubmed/25397468 http://dx.doi.org/10.7448/IAS.17.4.19722 Text en © 2014 Ciccarelli N et al; licensee International AIDS Society http://creativecommons.org/licenses/by/3.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Poster Sessions – Abstract P190 Ciccarelli, Nicoletta Fabbiani, Massimiliano Grima, Pierfrancesco Limiti, Silio Fanti, Iuri Mondi, Annalisa Gagliardini, Roberta D'Avino, Alessandro Borghetti, Alberto Cauda, Roberto Di Giambenedetto, Simona Liver fibrosis is associated with cognitive impairment in HIV-positive patients |
title |
Liver fibrosis is associated with cognitive impairment in HIV-positive patients |
title_full |
Liver fibrosis is associated with cognitive impairment in HIV-positive patients |
title_fullStr |
Liver fibrosis is associated with cognitive impairment in HIV-positive patients |
title_full_unstemmed |
Liver fibrosis is associated with cognitive impairment in HIV-positive patients |
title_short |
Liver fibrosis is associated with cognitive impairment in HIV-positive patients |
title_sort | liver fibrosis is associated with cognitive impairment in hiv-positive patients |
topic | Poster Sessions – Abstract P190 |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4225249/ https://www.ncbi.nlm.nih.gov/pubmed/25397468 http://dx.doi.org/10.7448/IAS.17.4.19722 |
work_keys_str_mv | AT ciccarellinicoletta liverfibrosisisassociatedwithcognitiveimpairmentinhivpositivepatients AT fabbianimassimiliano liverfibrosisisassociatedwithcognitiveimpairmentinhivpositivepatients AT grimapierfrancesco liverfibrosisisassociatedwithcognitiveimpairmentinhivpositivepatients AT limitisilio liverfibrosisisassociatedwithcognitiveimpairmentinhivpositivepatients AT fantiiuri liverfibrosisisassociatedwithcognitiveimpairmentinhivpositivepatients AT mondiannalisa liverfibrosisisassociatedwithcognitiveimpairmentinhivpositivepatients AT gagliardiniroberta liverfibrosisisassociatedwithcognitiveimpairmentinhivpositivepatients AT davinoalessandro liverfibrosisisassociatedwithcognitiveimpairmentinhivpositivepatients AT borghettialberto liverfibrosisisassociatedwithcognitiveimpairmentinhivpositivepatients AT caudaroberto liverfibrosisisassociatedwithcognitiveimpairmentinhivpositivepatients AT digiambenedettosimona liverfibrosisisassociatedwithcognitiveimpairmentinhivpositivepatients |