In:
Frontiers in Neurology, Frontiers Media SA, Vol. 12 ( 2021-2-11)
Abstract:
Cognitive impairment remains frequent and heterogeneous in presentation and severity among virally suppressed (VS) women with HIV (WWH). We identified cognitive profiles among 929 VS-WWH and 717 HIV-uninfected women from 11 Women's Interagency HIV Study sites at their first neuropsychological (NP) test battery completion comprised of: Hopkins Verbal Learning Test-Revised, Trail Making, Symbol Digit Modalities, Grooved Pegboard, Stroop, Letter/Animal Fluency, and Letter-Number Sequencing. Using 17 NP performance metrics (T-scores), we used Kohonen self-organizing maps to identify patterns of high-dimensional data by mapping participants to similar nodes based on T-scores and clustering those nodes. Among VS-WWH, nine clusters were identified (entropy = 0.990) with four having average T-scores ≥45 for all metrics and thus combined into an “unimpaired” profile ( n = 311). Impaired profiles consisted of weaknesses in: (1) sequencing ( Profile-1 ; n = 129), (2) speed ( Profile-2 ; n = 144), (3) learning + recognition ( Profile-3 ; n = 137), (4) learning + memory ( Profile-4 ; n = 86), and (5) learning + processing speed + attention + executive function ( Profile-5 ; n = 122). Sociodemographic, behavioral, and clinical variables differentiated profile membership using Random Forest models. The top 10 variables distinguishing the combined impaired vs. unimpaired profiles were: clinic site, age, education, race, illicit substance use, current and nadir CD4 count, duration of effective antiretrovirals, and protease inhibitor use. Additional variables differentiating each impaired from unimpaired profile included: depression, stress-symptoms, income ( Profile-1 ); depression, employment ( Profile 2 ); depression, integrase inhibitor (INSTI) use ( Profile-3 ); employment, INSTI use, income, atazanavir use, non-ART medications with anticholinergic properties ( Profile-4 ); and marijuana use ( Profile-5 ). Findings highlight consideration of NP profile heterogeneity and potential modifiable factors contributing to impaired profiles.
Type of Medium:
Online Resource
ISSN:
1664-2295
DOI:
10.3389/fneur.2021.604984
DOI:
10.3389/fneur.2021.604984.s001
Language:
Unknown
Publisher:
Frontiers Media SA
Publication Date:
2021
detail.hit.zdb_id:
2564214-5
Permalink