Journal of the International Neuropsychological Society

Research Articles

Neurocognitive Effects of HIV, Hepatitis C, and Substance Use History

Kathryn N. Devlina1, Assawin Gongvatanaa1a2, Uraina S. Clarka1a2, Jesse D. Chasmana1a2, Michelle L. Westbrooka1a3, Karen T. Tashimaa3a4, Bradford Naviaa5 and Ronald A. Cohena1a2 c1

a1 Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, Rhode Island

a2 Department of Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown University, Providence, Rhode Island

a3 Center for AIDS Research, The Miriam Hospital, Providence, Rhode Island

a4 Department of Medicine, The Warren Alpert Medical School of Brown University, Providence, Rhode Island

a5 Tufts University School of Medicine, Boston, Massachusetts

Abstract

HIV-associated neurocognitive dysfunction persists in the highly active antiretroviral therapy (HAART) era and may be exacerbated by comorbidities, including substance use and hepatitis C virus (HCV) infection. However, the neurocognitive impact of HIV, HCV, and substance use in the HAART era is still not well understood. In the current study, 115 HIV-infected and 72 HIV-seronegative individuals with significant rates of lifetime substance dependence and HCV infection received comprehensive neuropsychological assessment. We examined the effects of HIV serostatus, HCV infection, and substance use history on neurocognitive functioning. We also examined relationships between HIV disease measures (current and nadir CD4, HIV RNA, duration of infection) and cognitive functioning. Approximately half of HIV-infected participants exhibited neurocognitive impairment. Detectable HIV RNA but not HIV serostatus was significantly associated with cognitive functioning. HCV was among the factors most consistently associated with poorer neurocognitive performance across domains, while substance use was less strongly associated with cognitive performance. The results suggest that neurocognitive impairment continues to occur in HIV-infected individuals in association with poor virologic control and comorbid conditions, particularly HCV coinfection. (JINS, 2012, 18, 68–78)

(Received March 23 2011)

(Revised September 09 2011)

(Accepted September 12 2011)

Correspondence:

c1 Correspondence and reprint requests to: Ronald A. Cohen, Centers for Behavioral & Preventive Medicine, Coro Building, Suite 314, One Hoppin Street, Providence, RI 02903. E-mail: rcohen@lifespan.org

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