Neurocognitive impact of substance use in HIV infection.
Neurocognitive impact of substance use in HIV infection.
复制标题
DOI：
10.1097/qai.0b013e318229ba41
复制
发表时间：
2011-10-01
期刊：
影响因子：
--
通讯作者：
CHARTER Group
中科院分区：
文献类型：
--
作者：
Byrd DA;Fellows RP;Morgello S;Franklin D;Heaton RK;Deutsch R;Atkinson JH;Clifford DB;Collier AC;Marra CM;Gelman B;McCutchan JA;Duarte NA;Simpson DM;McArthur J;Grant I;CHARTER Group
为了确定在HIV相关神经认知障碍(HAND)研究中混淆物质使用(SU)的严重性，我们研究了参加CNS HIV抗逆转录病毒治疗效果研究(CHECH)的参与者SU病史与神经认知损害(NCI)的关系。在排除了有急性中毒的行为证据和可独立解释NCI的因素史(例如中风)的病例后，对399名参与者的基线人口统计、医学、SU和神经认知数据进行了分析。NCI的潜在SU风险由以下标准确定：终生SU DSM-IV诊断、标记终生SU的自我报告或尿毒学阳性(UTOX)。参与者被分成三组：无SU组(N=134)，非症状性SU组(N=131)，综合征性SU组(N=134)，并在识字水平、最低CD4和抑郁症状方面匹配。虽然大约50%的参与者被诊断为手部疾病，但神经认知总结分数的MANCOVA(UTOX的协变性)显示SU状态没有显著影响。相关分析表明，终生海洛因剂量与记忆力差和工作记忆之间以及大麻和可卡因使用与更好的语言流利性之间的相关性较弱。这些数据表明，在那些有和没有药物滥用史的人中，艾滋病毒的神经认知影响的频率大致相同，在与可能导致NCI的其他因素等同的情况下。因此，对神经艾滋病及其治疗的研究不需要排除此类病例。然而，急性SU和当前SU障碍对手部的影响还需要进一步研究。
To determine how serious a confound substance use (SU) might be in studies on HIV-associated neurocognitive disorder (HAND) we examined the relationship of SU history to neurocognitive impairment (NCI) in participants enrolled in the CNS HIV Antiretroviral Therapy Effects Research (CHARTER) study. After excluding cases with behavioral evidence of acute intoxication and histories of factors that independently could account for NCI (e.g., stroke), baseline demographic, medical, SU, and neurocognitive data were analyzed from 399 participants. Potential SU risk for NCI was determined by the following criteria: lifetime SU DSM-IV diagnosis, self-report of marked lifetime SU, or positive urine toxicology (UTOX). Participants were divided into three groups: no SU (N = 134), Non-syndromic SU (N = 131), syndromic SU (N = 134) and matched on literacy level, nadir CD4, and depressive symptoms. While approximately 50% of the participants were diagnosed with HAND, a MANCOVA of neurocogntive summary scores, covarying for UTOX, revealed no significant effect of SU status. Correlational analyses indicated weak associations between lifetime heroin dosage and poor recall and working memory, as well as between cannabis and cocaine use and better verbal fluency. These data indicate that HIV neurocognitive effects are seen at about the same frequency in those with and without historic substance abuse, in cases that are equated on other factors that might contribute to NCI. Therefore, studies on neuroAIDS and its treatment need not exclude such cases. However, the effects of acute SU and current SU disorders on HAND require further study.