Sustained attention and vigilance deficits associated with HIV and a history of methamphetamine dependence.
Sustained attention and vigilance deficits associated with HIV and a history of methamphetamine dependence.
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DOI：
10.1016/j.drugalcdep.2020.108245
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发表时间：
2020-10-01
影响因子：
4.2
通讯作者：
Translational Methamphetamine AIDS Research Center (TMARC)
中科院分区：
文献类型：
--
作者：
Pocuca N;Young JW;MacQueen DA;Letendre S;Heaton RK;Geyer MA;Perry W;Grant I;Minassian A;Translational Methamphetamine AIDS Research Center (TMARC)
人类免疫缺陷病毒(HIV)相关的神经认知障碍持续存在于抗逆转录病毒治疗的时代。艾滋病毒携带者(PWH)中升高并与神经认知障碍独立相关的一个因素是甲基苯丙胺依赖(METH)。这种依赖可能会推迟艾滋病毒的诊断(从而推迟抗逆转录病毒治疗的开始)，从而进一步增加PWH患者的认知障碍，这被认为是PWH患者认知障碍持续存在的原因，尽管随后的治疗相关病毒载量抑制(VLS；血浆或脑脊液中每毫升≤病毒50个拷贝)。这项研究考察了HIV和冰毒病史对持续注意和警觉认知领域的独立和联合(相加和协同)影响，同时控制了VLS。参与者包括205名(中位数年龄=44岁；77%男性；HIV-/meth-n=67；HIV+/meth-n=49；HIV-/meth+n=36；HIV+/meth+n=53)，他们完成了Conners‘s和5-Choice连续操作测试(CPT)。冰毒参与者在持续注意力和警觉性方面表现出缺陷；然而，在排除尿毒学筛查呈甲基苯丙胺阳性的参与者后，这些影响并不显著。对照VLS，PWH没有更差的持续注意力和警觉性，但始终显示出比HIV参与者更慢的跨区反应时间。在持续的关注和警觉上没有艾滋病毒和冰毒的相互作用。最近在冰毒人群中使用甲基苯丙胺和可检测到的病毒载量不利于持续的关注和警惕。这些发现突显了迅速诊断艾滋病毒、启动抗逆转录病毒治疗和冰毒使用干预措施的必要性。
Human immunodeficiency virus (HIV)-associated neurocognitive disorders persist in the era of antiretroviral therapy. One factor that is elevated among persons with HIV (PWH) and independently associated with neurocognitive impairment is methamphetamine dependence (METH). Such dependence may further increase cognitive impairment among PWH, by delaying HIV diagnosis (and thus, antiretroviral therapy initiation), which has been posited to account for persistent cognitive impairment among PWH, despite subsequent treatment-related viral load suppression (VLS; ≤50 copies of the virus per milliliter in plasma or cerebrospinal fluid). This study examined the independent and combined (additive versus synergistic) effects of HIV and history of METH on the sustained attention and vigilance cognitive domain, while controlling for VLS. Participants included 205 (median age=44 years; 77% males; HIV-/METH- n=67; HIV+/METH - n=49; HIV-/METH+ n=36; HIV+/METH+ n=53) individuals enrolled in the Translational Methamphetamine AIDS Research Center, who completed Conners’ and the 5-Choice continuous performance tests (CPTs). METH participants exhibited deficits in sustained attention and vigilance; however, these effects were not significant after excluding participants who had a positive urine toxicology screen for methamphetamine. Controlling for VLS, PWH did not have worse sustained attention and vigilance, but consistently displayed slower reaction times across blocks, relative to HIV- participants. There was no HIV x METH interaction on sustained attention and vigilance. Recent methamphetamine use among METH people and detectable viral loads are detrimental to sustained attention and vigilance. These findings highlight the need for prompt diagnosis of HIV and initiation of antiretroviral therapy, and METH use interventions.
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影响因子：
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DOI：
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发表时间：
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期刊：
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影响因子：
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