Loneliness in Older Black Adults with Human Immunodeficiency Virus Is Associated with Poorer Cognition

Background: The human immunodeficiency virus (HIV) is associated with cognitive impairment, and loneliness is associated with cognitive decline in old age. Older Black adults with HIV may be at particular risk of loneliness due to stigma and lack of social resources. Objective: We tested the hypotheses that (1) older Black adults with HIV would show greater loneliness than older White adults with HIV, and (2) greater loneliness among older Black adults with HIV would be associated with poorer cognitive function. Methods: A total of 370 participants (177 with HIV, 193 without HIV; mean age 58.8 years, standard deviation 6.2 years; mean education 13.4 years, standard deviation 2.9 years; 73.9% male, 68.9% Black) in a community-based cross-sectional study of the Rush Center of Excellence on Disparities in HIV and Aging (CEDHA) completed a 5-item self-report scale used to measure emotional loneliness and a battery of cognitive measures. Results: Contrary to our expectations, older Black adults indicated less overall loneliness than White adults (β = -0.3893, SE = 0.1466, p = 0.0087) in models controlling for the effects of age, education, sex, global cognition, and income. However, in models with cognitive function as the outcome, an interaction between race and loneliness was observed, such that older Black adults who indicated greater loneliness showed poorer cognitive function relative to White adults (β = -0.2736, SE = 0.1138, p = 0.0174). Conclusion: Older Black adults with HIV reported less loneliness than older White adults; however, the inverse association between loneliness and cognitive function was stronger in Black than White older adults. Additional work is needed to elucidate the mechanisms underlying this interaction.

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HUBUNGAN ANTARA JUMLAH LIMFOSIT TCD4+ DENGAN GANGGUAN FUNGSI KOGNITIF PADA PASIEN TERINFEKSI HIV

Majalah Kedokteran Neurosains Perhimpunan Dokter Spesialis Saraf Indonesia ◽

10.52386/neurona.v36i3.72 ◽

2020 ◽

Vol 36 (3) ◽

Author(s):

Rilia Datan Sampepajung ◽

Audry Devisanty Wuysang ◽

Abdul Muis

Keyword(s):

Human Immunodeficiency Virus ◽

Cognitive Impairment ◽

Cognitive Function ◽

T Lymphocyte ◽

Cognitive Assessment ◽

Cross Sectional Study ◽

Montreal Cognitive Assessment ◽

Hiv Patients ◽

Cross Sectional ◽

Immunodeficiency Virus

CORRELATION BETWEEN QUANTITY OF CD4+ T LYMPHOCYTE AND COGNITIVE IMPAIRMENT IN PATIENTS WITH HIV INFECTIONABSTRACTIntroduction: CD4+T lymphocyte is a T-lymphocyte that has CD4 glycoprotein on its surface. The quantity of CD4+ T lymphocyte is associated with cognitive function impairment.Aim: To determine the correlation between the quantity of CD4+ T lymphocyte with the cognitive function impairment in patients infected by human immunodeficiency virus (HIV).Methods: This is a cross-sectional study on HIV patients at Wahidin Sudirohusodo Hospital, Makassar from October to December 2018. Cognitive function was assessed using Montreal Cognitive Assessment of Indonesian version (MoCA-Ina) and all infected HIV patients’ CD4+ T lymphocyte was counted through blood laboratory examination. The data processing used SPSS program.Results: There were 40 subjects with male majority (70%). Most subjects (75%) had low count of CD4+ T lymphocytes (<200cel/µL) and most of them (72.5%) had cognitive function impairment.Discussion: The CD4+T lymphocyte was associated significantly with executive and memory impairment in patients with HIV.Keywords: CD4+ T lymphocyte, cognitive impairment, HIVABSTRAKPendahuluan: Limfosit TCD4+ adalah limfosit T yang memiliki glikoprotein CD4 pada permukaan selnya. Jumlah limfosit TCD4+ telah diketahui berhubungan dengan gangguan fungsi kognitif.Tujuan: Mengetahui hubungan antara jumlah limfosit TCD4+ dengan gangguan fungsi kognitif pada pasien terinfeksi human immunodeficiency virus (HIV).Metode: Penelitian observasional dengan rancangan potong lintang terhadap pasien yang terinfeksi HIV di RSUP Dr. Wahidin Sudirohusodo, Makassar pada bulan Oktober-Desember 2018. Subjek dinilai fungsi kognitif menggunakan Montreal Cognitive Assessment versi Indonesia (MoCA-Ina) dan penghitungan jumlah limfosit TCD4+. Pengolahan data menggunakan program SPSS.Hasil: Terdapat 40 subjek yang mayoritas (70%) laki-laki. Terdapat 75% subjek memiliki kadar limfosit TCD4+ yang rendah (<200sel/µL) yang sebagian besarnya (72,5%) mengalami gangguan fungsi kognitif.Diskusi: Jumlah limfosit TCD4+ memiliki hubungan yang signifikan dengan komponen eksekutif dan memori dari fungsi kognitif pada pasien yang terinfeksi HIV.Kata kunci: Gangguan kognitif, HIV, limfosit TCD4+

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Correlation between Lymphocyte CD4 Count, Treatment Duration, Opportunistic Infection and Cognitive Function in Human Immunodeficiency Virus-Acquired Immunodeficiency Syndrome (HIV-AIDS) Patients

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2018.152 ◽

2018 ◽

Vol 6 (4) ◽

pp. 643-647 ◽

Cited By ~ 3

Author(s):

Fasihah Irfani Fitri ◽

Aldy Safruddin Rambe ◽

Aida Fitri

Keyword(s):

Human Immunodeficiency Virus ◽

Cognitive Function ◽

Opportunistic Infections ◽

Cross Sectional Study ◽

Cd4 Count ◽

Aids Patients ◽

Cross Sectional ◽

Immunodeficiency Virus ◽

Cd4 Lymphocyte ◽

Hiv Aids

BACKGROUND: Human immunodeficiency virus (HIV) infection is an epidemic worldwide, despite the marked benefits of antiretroviral therapy (ARV) in reducing severe HIV-associated dementia. A milder form of neurocognitive disorders are still prevalent and remain a challenge.AIM: This study aimed to determine the correlation between plasma cluster of differentiation 4 (CD4) lymphocyte, duration of ARV treatment, opportunistic infections, and cognitive function in HIV-AIDS patients.METHODS: A cross-sectional study involving 85 HIV-AIDS patients was conducted at Adam Malik General Hospital Medan, Indonesia. All subjects were subjected to physical, neurologic examination and Montreal Cognitive Assessment-Indonesian Version (MoCA-INA) to assess cognitive function and measurement of lymphocyte CD4 counts.RESULTS: Out of the 85 subjects evaluated, the proportion concerning sexes include 52 males (61.2 %) and 33 females (38.8%). The mean age was 38.53 ± 9.77 years old. There was a significant correlation between CD4 lymphocyte counts and MoCA-INA score (r = 0.271, p = 0.012), but there was no significant correlation between duration of ARV treatment and MoCA-INA score. There was also no difference in MoCA-INA score based on the presence of opportunistic infection.CONCLUSION: Lymphocyte CD4 count was independently correlated with cognitive function in HIV-AIDS patients.

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Uptake of the Ithaka mobile application in Johannesburg, South Africa, for human immunodeficiency virus self-testing result reporting

Southern African Journal of HIV Medicine ◽

10.4102/sajhivmed.v22i1.1197 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Alex E. Fischer ◽

Mothepane Phatsoane ◽

Mohammed Majam ◽

Luke Shankland ◽

Musaed Abrahams ◽

...

Keyword(s):

Human Immunodeficiency Virus ◽

Small Sample Size ◽

Linkage To Care ◽

Cross Sectional Study ◽

Small Sample ◽

Self Report ◽

Cross Sectional ◽

Support Tool ◽

Self Testing ◽

Immunodeficiency Virus

Background: Human immunodeficiency virus self-testing (HIVST) can reduce facility-based HIV testing barriers; however, no proven applications exist with widespread uptake for self-reporting or linkage to care. Mobile health (mHealth) applications (apps) have shown high usability and feasibility scores, so Ithaka was developed for South Africans to self-report HIVST results outside clinical settings.Objectives: This study investigated the use of Ithaka as a support tool for HIVST users, specifically the ability to self-report results.Method: This cross-sectional study was conducted from November 2018 to June 2019. At existing HIVST distribution sites, individuals were given HIVST kits and then invited to use Ithaka. Participants could test at home and report their results through the app anytime. Ithaka tracked when people logged-on, registered, received counselling and reported results. Post-study surveys on user experience were also conducted.Results: Of 751 participants, 531 (70.7%) logged onto the app, 412 (54.9%) registered, 295 (39.3%) received counselling and 168 (22.4%) self-reported results. Participants strongly agreed that Ithaka was useful and that it was easy to upload results. Forty-one participants completed a post-test survey, and 39/41 (95.1%) completed the app journey. Most participants (36/41;87.8%) had no challenges, although 2/41 (4.9%) cited perceived data costs, 2/41 (4.9%) difficulty uploading results and 1/41 (2.4%) language, as challenges.Conclusion: Despite the small sample size, this study has shown that HIVST participants under pragmatic conditions were willing and able to self-report results via the app, whilst also identifying areas of improvement for scaling up.

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Serological prevalence of rubella, cytomegalovirus, herpes simplex virus, treponema pallidum and human immunodeficiency virus in antenatal women with bad obstetric history – A cross sectional study

MedPulse International Journal of Microbiology ◽

10.26611/10081125 ◽

2019 ◽

Vol 11 (2) ◽

pp. 28-34

Author(s):

Shama Taj K R ◽

Keyword(s):

Human Immunodeficiency Virus ◽

Herpes Simplex Virus ◽

Herpes Simplex ◽

Treponema Pallidum ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Obstetric History ◽

Immunodeficiency Virus ◽

Simplex Virus

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SAT0078 SAFETY OF LOW DOSE METHOTREXATE (MTX) IN HUMAN IMMUNODEFICIENCY VIRUS (HIV) INFECTION

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.2968 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 974.2-974

Author(s):

A. Gunay ◽

A. Davidson ◽

I. Colmegna ◽

D. Lacaille ◽

H. Loewen ◽

...

Keyword(s):

Human Immunodeficiency Virus ◽

Adverse Events ◽

Low Dose ◽

Opportunistic Infections ◽

Case Reports ◽

Cross Sectional Study ◽

Study Quality ◽

Sectional Study ◽

Cross Sectional ◽

Immunodeficiency Virus

Background:Increased awareness of the efficacy of MTX in rheumatic disease is leading to more MTX use in patients from HIV endemic areas. While HIV related immunosuppression may contribute to improvement of some rheumatic diseases, immune reconstitution from highly active antiretroviral therapy (HAART) may lead to exacerbation or presentation of autoimmune disorders for which MTX therapy may be warranted. Most management guidelines for rheumatic disease do not address MTX use in the context of HIV.Objectives:To systematically review the published literature on the safety of using MTX ≤30 mg per week in HIV.Methods:We searched CINAHL, Embase, Global, MEDLINE and World of Science databases (Jan 1990 to May 2018) for terms including ‘methotrexate’ and ‘human immunodeficiency virus’. We also searched citations from review articles. Titles, abstracts or full manuscripts were screened independently by 2 reviewers to identify studies reporting HIV in patients taking MTX. Study quality was assessed using the McGill Mixed Methods Appraisal Tool (MMAT). Data was extracted on MTX and HIV adverse events (MTX toxicity, HIV viral load, CD4 count). Descriptive summaries are presented for studies providing outcomes in patients taking MTX ≤30 mg per week.Results:After removing duplicates and studies not meeting criteria or not providing sufficient information, 42 of the 2714 identified reports were included (1 clinical trial, 2 cohort, 1 cross-sectional study, 38 case reports/case series). Most reports (81%) originated from USA or Europe. Study quality was generally good with most studies fulfilling 50-100% of MMAT criteria. The randomized controlled trial (USA) assessing MTX on atherosclerotic disease in HIV showed that adverse events were more common in MTX versus placebo (12.8% vs 5.6%, p non-inferiority <0.05) and included infection, transient CD4 and CD8 drop, pulmonary toxicity, and death (1 attributed to MTX/HIV, 1 unrelated). One cohort study (South Africa) reported 43 RA patients on MTX who acquired HIV. In this cohort, RA generally improved despite only 5 individuals continuing MTX. No data on MTX adverse event rates was reported. One cohort study (USA) reported 13 HIV patients with myositis. One received MTX (with other immunosuppression) without MTX adverse effects but died due to AIDS. A cross-sectional study (France) of 43 HIV pts with autoimmune disease reported one patient on MTX (and other immunosuppression) developed an adverse event (cytopenia) compared to 5/33 patients not on MTX (cytopenia). The 38 case reports/series described 54 individuals with HIV receiving MTX. Of these studies, 27 (describing 42 subjects) reported on MTX adverse events and 35 (describing 46 subjects) reported on HIV adverse events. MTX adverse events developed in 29 subjects (hematologic 13, renal/hepatic 1, opportunistic infections 10, other events 2). HIV adverse events were noted in 23 subjects (Kaposi’s sarcoma 4, CD4 decrease 16, HIV viral titer increase 4). Five deaths were reported (2 infection, 1 infection and wasting, 2 HIV related deaths). Most subjects also received corticosteroids or other immunosuppressants including biologics.Conclusion:There remains limited data on the safety of low dose MTX in HIV. Surveillance for HIV is warranted for individuals on MTX who are at risk for acquiring HIV. Caution and careful monitoring for MTX toxicity, opportunistic infections and HIV state is suggested if MTX is used in the setting of HIV particularly if combined with other immunosuppression.References:[1] Clin Infectious Disease 2019:68[2] J Rheumatology 2014:41[3] Arthritis and Rheumatism 2003:49[4] Medicine 2017:96Acknowledgments :Funding from International League Against RheumatismMcGill University Global Health Scholar AwardsDisclosure of Interests:Alize Gunay: None declared, Anna Davidson: None declared, Ines Colmegna: None declared, Diane Lacaille: None declared, Hal Loewen: None declared, Michele Meltzer: None declared, Yewondwossen Mengistu: None declared, Rosie Scuccimarri: None declared, Zenebe Yirsaw: None declared, Sasha Bernatsky: None declared, Carol Hitchon Grant/research support from: UCB Canada; Pfizer Canada

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Consistent Patterns of Change during the Divergence of Human Immunodeficiency Virus Type 1 Envelope from That of the Inoculated Virus in Simian/Human Immunodeficiency Virus-Infected Macaques

Journal of Virology ◽

10.1128/jvi.80.2.999-1014.2006 ◽

2006 ◽

Vol 80 (2) ◽

pp. 999-1014 ◽

Cited By ~ 50

Author(s):

W.M. Blay ◽

S. Gnanakaran ◽

B. Foley ◽

N. A. Doria-Rose ◽

B. T. Korber ◽

...

Keyword(s):

Human Immunodeficiency Virus ◽

Disulfide Bonds ◽

Neutralizing Antibodies ◽

Outer Region ◽

Synonymous Substitution ◽

Cross Sectional Study ◽

Macaca Nemestrina ◽

Cross Sectional ◽

Immunodeficiency Virus ◽

And Shifts

ABSTRACT We have analyzed changes to proviral Env gp120 sequences and the development of neutralizing antibodies (NAbs) during 1 year of simian/human immunodeficiency virus SHIV-89.6P infection in 11 Macaca nemestrina macaques. Seven macaques had significant env divergence from that of the inoculum, and macaques with greater divergence had higher titers of homologous NAbs. Substitutions in sequons encoding potential N-linked glycosylation sites (PNGs) were among the first to be established, although overall the total number of sequons did not increase significantly. The majority (19 of 23) of PNGs present in the inoculum were conserved in the sequences from all macaques. Statistically significant variations in PNGs occurred in multiple macaques within constrained regions we term “hot spots,” resulting in the selection of sequences more similar to the B consensus. These included additions on V1, the N-terminal side of V4, and the outer region of C2. Complex mutational patterns resulted in convergent PNG shifts in V2 and V5. Charge changes in Env V1V2, resulting in a net acidic charge, and a proline addition in V5 occurred in several macaques. Molecular modeling of the 89.6P sequence showed that the conserved glycans lie on the silent face of Env and that many are proximal to disulfide bonds, while PNG additions and shifts are proximal to the CD4 binding site. Nonsynonymous-to-synonymous substitution ratios suggest that these changes result from selective pressure. This longitudinal and cross-sectional study of mutations in human immunodeficiency virus (HIV) env in the SHIV background provides evidence that there are more constraints on the configuration of the glycan shield than were previously appreciated.

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Nutritional Attitudes of Homosexual People Living with Human Immunodeficiency Virus (HIV) in Chongqing, Southwest China: A Cross-Sectional Study

International Quarterly of Community Health Education ◽

10.2190/iq.34.1.g ◽

2013 ◽

Vol 34 (1) ◽

pp. 87-100 ◽

Cited By ~ 1

Author(s):

Wenjie Zhou ◽

Rui Ma ◽

Manoj Sharma ◽

Yong Zhao

Keyword(s):

Human Immunodeficiency Virus ◽

Southwest China ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Immunodeficiency Virus

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A High Prevalence Rate of a Positive Screen for Cognitive Impairment in Patients With Human Immunodeficiency Virus Attending an Irish Clinic

Open Forum Infectious Diseases ◽

10.1093/ofid/ofw242 ◽

2016 ◽

Vol 4 (1) ◽

Cited By ~ 2

Author(s):

Patricia H. McNamara ◽

Robert Coen ◽

Janice Redmond ◽

Colin P. Doherty ◽

Colm Bergin

Keyword(s):

Human Immunodeficiency Virus ◽

Cognitive Impairment ◽

Large Scale ◽

Screening Program ◽

Cross Sectional Study ◽

Hiv Positive ◽

Study Cohort ◽

Cross Sectional ◽

Positive Screen ◽

Immunodeficiency Virus

Abstract Background Human immunodeficiency virus (HIV)-associated neurocognitive disorders occurs in 20%–50% of HIV-positive patients. We undertook this study to assess the prevalence of a positive screen for cognitive impairment in the clinic population at our institution and to demonstrate the feasibility of implementing a screening program in routine clinical encounters. Methods This was a cross-sectional study, and patients were recruited prospectively between December 2010 and February 2013. Inclusion criteria were as follows: patients were HIV positive, over the age of 18, capable of giving informed consent, and had sufficient ability to communicate in English. Patients were screened for cognitive impairment using the Brief Neurocognitive Screen. Results A total of 604 patients were recruited, and 51.5% had a positive screen for cognitive impairment. The majority of the study cohort were male (78.8%), mean age was 40.9 (standard deviation, 10.2) years, 70.9% were Irish, the most common mode of transmission was men who have sex with men (49.3%), 83% were on antiretroviral therapy, and 88.7% were virally suppressed. Logistic regression showed that the main factors predictive of a positive screen for cognitive impairment were the endorsement of cognitive symptoms (P = .024), being born in Africa (P < .000001), the use of benzodiazepines (P = .00341), being unemployed (P = .008), and consumption of more than 40 units of alcohol weekly (P = .035). There was a positive screen for depression in 9.1% and a positive screen for anxiety in 24.5%. Conclusions The study highlights the necessity for a structured, prospective, large-scale screening program for cognitive impairment across countries with limited resources and demonstrates the feasibility of easily implementing this with minimal training.

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