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Neurocognitive status and risk of mortality among people living with human immunodeficiency virus: an 18-year retrospective cohort study
HIV-related neurocognitive impairment (NCI) may increase the risk of death. However, a survival disadvantage for patients with NCI has not been well studied in the post-combination antiretroviral therapy (cART) era. Specifically, limited research has been conducted considering the reversible nature...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Nature Publishing Group UK
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7881128/ https://www.ncbi.nlm.nih.gov/pubmed/33580123 http://dx.doi.org/10.1038/s41598-021-83131-1 |
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author | Naveed, Zaeema Fox, Howard S. Wichman, Christopher S. Alam, Morshed May, Pamela Arcari, Christine M. Meza, Jane Totusek, Steven Baccaglini, Lorena |
author_facet | Naveed, Zaeema Fox, Howard S. Wichman, Christopher S. Alam, Morshed May, Pamela Arcari, Christine M. Meza, Jane Totusek, Steven Baccaglini, Lorena |
author_sort | Naveed, Zaeema |
collection | PubMed |
description | HIV-related neurocognitive impairment (NCI) may increase the risk of death. However, a survival disadvantage for patients with NCI has not been well studied in the post-combination antiretroviral therapy (cART) era. Specifically, limited research has been conducted considering the reversible nature and variable progression of the impairment and this area demands further evaluation. We performed multivariable Cox proportional hazards modeling to assess the association between baseline NCI (global T scores) and mortality. A joint modeling approach was then used to model the trajectory of global neurocognitive functioning over time and the association between neurocognitive trajectory and mortality. Among the National NeuroAIDS Tissue Consortium’s (NNTC) HIV-infected participants, we found a strong negative association between NCI and mortality in the older age groups (e.g., at age = 55, HR = 0.79; 95% CI 0.64–0.99). Three neurocognitive sub-domains (abstraction and executive functioning, speed of information processing, and motor) had the strongest negative association with mortality. Joint modelling indicated a 33% lower hazard for every 10-unit increase in global T scores (HR = 0.67; 95% CI 0.56–0.80). The study identified older HIV-infected individuals with NCI as a group needing special attention for the longevity of life. The study has considerable prognostic utility by not only predicting mortality hazard, but also future cognitive status. |
format | Online Article Text |
id | pubmed-7881128 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Nature Publishing Group UK |
record_format | MEDLINE/PubMed |
spelling | pubmed-78811282021-02-16 Neurocognitive status and risk of mortality among people living with human immunodeficiency virus: an 18-year retrospective cohort study Naveed, Zaeema Fox, Howard S. Wichman, Christopher S. Alam, Morshed May, Pamela Arcari, Christine M. Meza, Jane Totusek, Steven Baccaglini, Lorena Sci Rep Article HIV-related neurocognitive impairment (NCI) may increase the risk of death. However, a survival disadvantage for patients with NCI has not been well studied in the post-combination antiretroviral therapy (cART) era. Specifically, limited research has been conducted considering the reversible nature and variable progression of the impairment and this area demands further evaluation. We performed multivariable Cox proportional hazards modeling to assess the association between baseline NCI (global T scores) and mortality. A joint modeling approach was then used to model the trajectory of global neurocognitive functioning over time and the association between neurocognitive trajectory and mortality. Among the National NeuroAIDS Tissue Consortium’s (NNTC) HIV-infected participants, we found a strong negative association between NCI and mortality in the older age groups (e.g., at age = 55, HR = 0.79; 95% CI 0.64–0.99). Three neurocognitive sub-domains (abstraction and executive functioning, speed of information processing, and motor) had the strongest negative association with mortality. Joint modelling indicated a 33% lower hazard for every 10-unit increase in global T scores (HR = 0.67; 95% CI 0.56–0.80). The study identified older HIV-infected individuals with NCI as a group needing special attention for the longevity of life. The study has considerable prognostic utility by not only predicting mortality hazard, but also future cognitive status. Nature Publishing Group UK 2021-02-12 /pmc/articles/PMC7881128/ /pubmed/33580123 http://dx.doi.org/10.1038/s41598-021-83131-1 Text en © The Author(s) 2021 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. |
spellingShingle | Article Naveed, Zaeema Fox, Howard S. Wichman, Christopher S. Alam, Morshed May, Pamela Arcari, Christine M. Meza, Jane Totusek, Steven Baccaglini, Lorena Neurocognitive status and risk of mortality among people living with human immunodeficiency virus: an 18-year retrospective cohort study |
title | Neurocognitive status and risk of mortality among people living with human immunodeficiency virus: an 18-year retrospective cohort study |
title_full | Neurocognitive status and risk of mortality among people living with human immunodeficiency virus: an 18-year retrospective cohort study |
title_fullStr | Neurocognitive status and risk of mortality among people living with human immunodeficiency virus: an 18-year retrospective cohort study |
title_full_unstemmed | Neurocognitive status and risk of mortality among people living with human immunodeficiency virus: an 18-year retrospective cohort study |
title_short | Neurocognitive status and risk of mortality among people living with human immunodeficiency virus: an 18-year retrospective cohort study |
title_sort | neurocognitive status and risk of mortality among people living with human immunodeficiency virus: an 18-year retrospective cohort study |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7881128/ https://www.ncbi.nlm.nih.gov/pubmed/33580123 http://dx.doi.org/10.1038/s41598-021-83131-1 |
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