Journal of the International Neuropsychological Society



Methamphetamine dependence increases risk of neuropsychological impairment in HIV infected persons


JULIE D.  RIPPETH  a1 , ROBERT K.  HEATON  a1 a2 , CATHERINE L.  CAREY  a2 , THOMAS D.  MARCOTTE  a1 a2 , DAVID J.  MOORE  a2 , RAUL  GONZALEZ  a2 , TANYA  WOLFSON  a1 , IGOR  GRANT  a1 a2 a3 c1 and THE HNRC  GROUP  a1
a1 Department of Psychiatry, University of California, San Diego School of Medicine, San Diego, California
a2 San Diego State University and University of California, San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California
a3 Veterans Affairs San Diego Healthcare System

Article author query
rippeth jd   [PubMed][Google Scholar] 
heaton rk   [PubMed][Google Scholar] 
carey cl   [PubMed][Google Scholar] 
marcotte td   [PubMed][Google Scholar] 
moore dj   [PubMed][Google Scholar] 
gonzalez r   [PubMed][Google Scholar] 
wolfson t   [PubMed][Google Scholar] 
grant i   [PubMed][Google Scholar] 
group th   [PubMed][Google Scholar] 

Abstract

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/methamphetamine 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. (JINS, 2004, 10, 1–14.) a

(Received December 4 2002)
(Revised March 11 2003)
(Accepted March 17 2003)


Key Words: HIV infection; Methamphetamine; Stimulants; Drug effects; Neuropsychology.

Correspondence:
c1 Reprint requests to: Igor Grant, MD, HIV Neurobehavioral Research Center, 150 West Washington Street, 2nd Floor, San Diego, CA 92103.


Footnotes

a Note: Dr. Erin D. Bigler served as action editor during the course of this review.