دورية أكاديمية
أعرض في EDS

Coagulation imbalance and neurocognitive functioning in older HIV-positive adults on suppressive antiretroviral therapy.

التفاصيل البيبلوغرافية
العنوان: Coagulation imbalance and neurocognitive functioning in older HIV-positive adults on suppressive antiretroviral therapy.
المؤلفون: Montoya JL; aSDSU/UCSD Joint Doctoral Program in Clinical Psychology bDepartment of Psychiatry cDepartment of Family Medicine and Public Health dDepartment of Neurosciences eDepartment of Medicine, University of California, San Diego, La Jolla, California fDepartment of Pharmacy Practice, University of Buffalo, Buffalo, New York, USA., Iudicello J, Oppenheim HA, Fazeli PL, Potter M, Ma Q, Mills PJ, Ellis RJ, Grant I, Letendre SL, Moore DJ
مؤلفون مشاركون: HIV Neurobehavioral Research Program (HNRP) Group
المصدر: AIDS (London, England) [AIDS] 2017 Mar 27; Vol. 31 (6), pp. 787-795.
نوع المنشور: Journal Article; Research Support, N.I.H., Extramural
اللغة: English
بيانات الدورية: Publisher: Lippincott Williams & Wilkins Country of Publication: England NLM ID: 8710219 Publication Model: Print Cited Medium: Internet ISSN: 1473-5571 (Electronic) Linking ISSN: 02699370 NLM ISO Abbreviation: AIDS Subsets: MEDLINE
أسماء مطبوعة: Publication: 1998- : London, England : Lippincott Williams & Wilkins
Original Publication: London : Gower Academic Journals, c1987-
مواضيع طبية MeSH: Sustained Virologic Response*, Anti-Retroviral Agents/*therapeutic use , Blood Coagulation Disorders/*epidemiology , HIV Infections/*complications , HIV Infections/*drug therapy , Neurocognitive Disorders/*epidemiology, Adult ; Cross-Sectional Studies ; Humans
مستخلص: Objectives: The aim of this study was to compare plasma biomarkers of coagulation between HIV-infected individuals and HIV-uninfected controls and to assess the impact of disturbances in coagulation on neurocognitive functioning in HIV.
Design: A cross-sectional study of 66 antiretroviral therapy treated, virally suppressed, HIV-infected and 34 HIV-uninfected older (≥50 years of age) adults.
Methods: Participants completed standardized neurobehavioral and neuromedical assessments. Neurocognitive functioning was evaluated using a well validated comprehensive neuropsychological battery. Plasma biomarkers associated with procoagulation (fibrinogen, p-selectin, tissue factor and von Willebrand factor), anticoagulation (antithrombin, protein C and thrombomodulin), fibrinolysis (d-dimer, plasminogen activator inhibitor-1 and plasminogen) were collected. Multivariable linear regression was used to test the interaction of HIV and coagulation on neurocognitive functioning.
Results: Most participants were male (78.0%) and non-Hispanic white (73.0%) with a mean age of 57.8 years. Among HIV-infected participants, mean estimated duration of HIV infection was 19.4 years and median current CD4 cell count was 654 cells/μl. Levels of soluble biomarkers of procoagulation, anticoagulation and fibrinolysis were comparable between the HIV serostatus groups. Coagulation and HIV had an interacting effect on neurocognitive functioning, such that greater coagulation imbalance was associated with poorer neurocognitive functioning among the HIV-infected participants. The moderating effect of coagulation on neurocognition was driven by procoagulant but not anticoagulant or fibrinolytic biomarkers.
Conclusions: Elevated levels of procoagulants may exert a particularly detrimental effect on neurocognitive functioning among older HIV-infected persons. A better understanding of the specific role of coagulation in the cause of HIV-associated neurocognitive disorders may lead to treatments aimed at reducing coagulopathy, thereby improving neurocognitive outcomes.
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معلومات مُعتمدة: P50 DA026306 United States DA NIDA NIH HHS; R00 AG048762 United States AG NIA NIH HHS; T32 DA031098 United States DA NIDA NIH HHS; L30 DA034362 United States DA NIDA NIH HHS; T35 AG026757 United States AG NIA NIH HHS; P30 MH062512 United States MH NIMH NIH HHS; R01 MH099987 United States MH NIMH NIH HHS; K23 DA037793 United States DA NIDA NIH HHS
المشرفين على المادة: 0 (Anti-Retroviral Agents)
تواريخ الأحداث: Date Created: 20170119 Date Completed: 20180102 Latest Revision: 20181113
رمز التحديث: 20240628
مُعرف محوري في PubMed: PMC5466004
DOI: 10.1097/QAD.0000000000001404
PMID: 28099190
قاعدة البيانات: MEDLINE
الوصف
تدمد:1473-5571
DOI:10.1097/QAD.0000000000001404