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. 2024 May 22;16(6):819.
doi: 10.3390/v16060819.

Lack of Association of Vascular Risk Factors with HIV-Associated Neurocognitive Disorders in cART-Treated Adults Aged ≥ 50 Years in Tanzania

Katherine A Flack  1 , Emma S Rainey  1 , Sarah J Urasa  2 , Sengua Koipapi  2 , Rajesh N Kalaria  1 , William P Howlett  2 , Elizabeta B Mukaetova-Ladinska  3   4 , Marieke C J Dekker  2 , William K Gray  5 , Richard W Walker  1   5 , Catherine L Dotchin  1   5 , Himidi Mtwaile  6 , Thomas C D Lewis  7 , Lydia G Stone  1 , Richard J Q McNally  1 , Philip C Makupa  8 , Stella-Maria Paddick  1   9
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Lack of Association of Vascular Risk Factors with HIV-Associated Neurocognitive Disorders in cART-Treated Adults Aged ≥ 50 Years in Tanzania

Katherine A Flack et al. Viruses. .

Abstract

HIV-associated neurocognitive disorders (HAND) are highly prevalent in those ageing with HIV. High-income country data suggest that vascular risk factors (VRFs) may be stronger predictors of HAND than HIV-disease severity, but data from sub-Saharan Africa are lacking. We evaluated relationships of VRFs, vascular end-organ damage and HAND in individuals aged ≥ 50 in Tanzania. c-ART-treated individuals were assessed for HAND using consensus criteria. The prevalence of VRFs and end organ damage markers were measured. The independent associations of VRFs, end organ damage and HAND were examined using multivariable logistic regression. Data were available for 153 individuals (median age 56, 67.3% female). HAND was highly prevalent (66.7%, 25.5% symptomatic) despite well-managed HIV (70.5% virally suppressed). Vascular risk factors included hypertension (34%), obesity (10.5%), hypercholesterolemia (33.3%), diabetes (5.3%) and current smoking (4.6%). End organ damage prevalence ranged from 1.3% (prior myocardial infarction) to 12.5% (left ventricular hypertrophy). Measured VRFs and end organ damage were not independently associated with HAND. The only significant association was lower diastolic BP (p 0.030, OR 0.969 (0.943-0.997). Our results suggest that vascular risk factors are not major drivers of HAND in this setting. Further studies should explore alternative aetiologies such as chronic inflammation.

Keywords: HIV; HIV-Associated Neurocognitive Disorders (HAND); cognitive impairment; older adults; sub-Saharan Africa; vascular risk factors.

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Conflict of interest statement

The authors declare no conflicts of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

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References

    1. UNAIDS Global HIV & AIDS Statistics–2020 Fact Sheet. [(accessed on 1 July 2021)]. Available online: https://www.unaids.org/en/resources/fact-sheet.
    1. Patel P., Rose C.E., Collins P.Y., Nuche-Berenguer B., Sahasrabuddhe V.V., Peprah E., Vorkoper S., Pastakia S.D., Rausch D., Levitt N.S. Noncommunicable diseases among HIV-infected persons in low-income and middle-income countries: A systematic review and meta-analysis. AIDS Lond. Engl. 2018;32((Suppl. 1)):S5. doi: 10.1097/QAD.0000000000001888. - DOI - PMC - PubMed
    1. Deeks S.G., Lewin S.R., Havlir D.V. The end of AIDS: HIV infection as a chronic disease. Lancet. 2013;382:1525–1533. doi: 10.1016/S0140-6736(13)61809-7. - DOI - PMC - PubMed
    1. Guaraldi G., Orlando G., Zona S., Menozzi M., Carli F., Garlassi E., Berti A., Rossi E., Roverato A., Palella F. Premature age-related comorbidities among HIV-infected persons compared with the general population. Clin. Infect. Dis. 2011;53:1120–1126. doi: 10.1093/cid/cir627. - DOI - PubMed
    1. Van Epps P., Kalayjian R.C. Human immunodeficiency virus and aging in the era of effective antiretroviral therapy. Infect. Dis. Clin. 2017;31:791–810. doi: 10.1016/j.idc.2017.07.007. - DOI - PubMed

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