Methamphetamine dependence increases risk of neuropsychological impairment in HIV infected persons
Methamphetamine dependence increases risk of neuropsychological impairment in HIV infected persons
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DOI：
10.1017/s1355617704101021
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发表时间：
2004-01-01
影响因子：
2.6
通讯作者：
Grant, I
中科院分区：
文献类型：
--
作者：
Rippeth, JD;Heaton, RK;Grant, I
艾滋病毒感染和甲基苯丙胺依赖都可能与脑功能障碍有关。然而，关于同时感染艾滋病毒和甲基苯丙胺依赖对认知的影响知之甚少。本研究包括4组200名参与者：HIV感染/甲基苯丙胺依赖（HIV+/METH+），HIV阴性/甲基苯丙胺依赖（HIV-/METH+），HIV感染/甲基苯丙胺非依赖（HIV+/METH-）和HIV阴性/甲基苯丙胺非依赖（HIV-/METH-）。研究组在年龄、教育和种族方面具有可比性，尽管HIV-/METH-组的女性明显更多。一个全面的，人口统计学校正的神经心理电池管理产生的全球性能评分和七个神经行为领域的分数。神经心理学损害的发生率由来自单独对照组的表现的截止分数确定，并用来自独立队列的更大样本的HIV+和HIV-参与者进行验证。与HIV-/METH-组（18%）相比，HIV+/METH+组（58%）、HIV-/METH+组（40%）和HIV+/METH-组（38%）的总体神经心理障碍率更高。非参数分析揭示了一个显着的单调的趋势，全球认知状态跨组，与最少的损害在对照组和最高的患病率的损害与并发的艾滋病毒感染和甲基苯丙胺依赖。结果表明，艾滋病毒感染和甲基苯丙胺依赖各自与神经心理缺陷，并建议，这些因素相结合，与添加剂有害的认知效应。这种加和性可能反映了涉及细胞毒性和凋亡机制的神经损伤的共同途径。
Both HIV infection and methamphetamine dependence can be associated with brain dysfunction. Little is known, however, about the cognitive effects of concurrent HIV infection and methamphetamine dependence. The present study included 200 participants in 4 groups: HIV infected/methamphetamine dependent (HIV+/METH+), HIV negative/methamphetamine dependent (HIV-/METH+), HIV infected/methamphetamine nondependent (HIV+/METH-), and HIV negative/metharnphetamine nondependent (HIV-/METH-). Study groups were comparable for age, education, and ethnicity, although the HIV-/METH- group had significantly more females. A comprehensive, demographically corrected neuropsychological battery was administered yielding a global performance score and scores for seven neurobehavioral domains. Rates of neuropsychological impairment were determined by cutoff scores derived from performances of a separate control group and validated with larger samples of HIV+ and HIV- participants from an independent cohort. Rates of global neuropsychological impairment were higher in the HIV+/METH+ (58%), HIV-/METH+ (40%) and HIV+/METH- (38%) groups compared to the HIV-/METH- (18%) group. Nonparametric analyses revealed a significant monotonic trend for global cognitive status across groups, with least impairment in the control group and highest prevalence of impairment in the group with concurrent HIV infection and methamphetamine dependence. The results indicate that HIV infection and methamphetamine dependence are each associated with neuropsychological deficits, and suggest that these factors in combination are associated with additive deleterious cognitive effects. This additivity may reflect common pathways to neural injury involving both cytotoxic and apoptotic mechanisms.