Higher frequency of dementia in older HIV-1 individuals - The Hawaii Aging with HIV-1 Cohort
Higher frequency of dementia in older HIV-1 individuals - The Hawaii Aging with HIV-1 Cohort
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DOI：
10.1212/01.wnl.0000134665.58343.8d
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发表时间：
2004-09-14
期刊：
影响因子：
9.9
通讯作者：
Sacktor, N
中科院分区：
文献类型：
--
作者：
Valcour, V;Shikuma, C;Sacktor, N
背景：抗逆转录病毒治疗提高了HIV-1感染者的存活率。HIV-1在老龄化人口中的神经流行病学影响还不是很清楚，特别是HIV相关性痴呆(HAD)的流行。方法：作者报告了对202名HIV-1血清阳性者的基线横断面分析，这些人被登记在夏威夷老年HIV队列的两组之一：年龄在50岁或以上的106人和年龄在20至39岁的年轻人(n=96)。在注册时获得了神经心理学、神经学、医学和实验室数据。在医生和神经心理学家的共识会议上，参与者的认知状态根据美国神经病学学会(1991)的标准进行了分类(研究案例定义)。结果：HAD在老年人(25.2%)比年轻人(13.7%)更常见(p=0.041)，与年轻组相比，老年人的OR值为2.13%(95%可信区间：1.02~4.44)。在调整了教育、种族、物质依赖、抗逆转录病毒药物治疗状况、病毒载量、CD4淋巴细胞计数和贝克抑郁问卷评分后，老年组个体患上这种疾病的几率是年轻组的3.26倍(1.32到8.07)。结论：在这个HIV-1队列中，年龄越大与HAD增加有关。潜在的机制尚不清楚，但似乎与HIV-1感染的持续时间无关。
Background: Antiretroviral therapy has improved survival for HIV-1-infected individuals. The neuroepidemiologic implications of HIV-1 in an aging population are not well known, particularly the prevalence of HIV-associated dementia ( HAD). Methods: The authors report a baseline cross-sectional analysis of 202 HIV-1-seropositive individuals enrolled into one of two groups of the Hawaii Aging with HIV Cohort: older ( 50 or more years old, n = 106) and younger ( 20 to 39 years old, n = 96). Neuropsychological, neurologic, medical, and laboratory data were obtained at enrollment. Participant cognitive status was classified ( research case definitions) using American Academy of Neurology ( 1991) criteria in a consensus conference of physicians and neuropsychologists. Results: HAD was more frequent in older (25.2%) compared to younger (13.7%) individuals ( p = 0.041) corresponding to an OR of 2.13 (95% CI: 1.02 to 4.44) for the older compared to the younger group. After adjusting for education, race, substance dependence, antiretroviral medication status, viral load, CD4 lymphocyte count, and Beck Depression Inventory score, the odds of having HAD among individuals in the older group was 3.26 (1.32 to 8.07) times that of the younger group. Conclusions: Older age is associated with increased HAD in this HIV-1 cohort. Underlying mechanisms are unclear but do not appear related to duration of HIV-1 infection.