ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2022
Higher Comorbidity Burden Predicts Worsening Neurocognitive Trajectories in People with Human Immunodeficiency Virus.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed.
- Smoldering in the sanctuary: HIV-associated brain injury in the ART era.The Journal of clinical investigation · 2026Review
- Comorbid HIV and Cocaine Use Exacerbate Accelerated Brain Aging.bioRxiv : the preprint server for biology · 2026Article
- Mobile cognitive testing captures divergent longitudinal trajectories of verbal learning in adults with and without HIV.Frontiers in digital health · 2026Article
- Risk factors for cognitive decline in persons with HIV.Current opinion in infectious diseases · 2025Review
- Individualizing Antiretroviral Therapy in the Older Patient.Drugs & aging · 2025Review
- Challenges of HIV Management in an Aging Population.Current HIV/AIDS reports · 2024Review
- CD4 nadir and neurocognitive trajectories in people living with HIV.Journal of neurovirology · 2024Article
- Biopsychosocial phenotypes in people with HIV in the CHARTER cohort.Brain communications · 2024Article
- Mechanisms underlying HIV-associated cognitive impairment and emerging therapies for its management.Nature reviews. Neurology · 2023Review
- Twelve-year neurocognitive decline in HIV is associated with comorbidities, not age: a CHARTER study.Brain : a journal of neurology · 2023Article
- Declining Prevalence of Human Immunodeficiency Virus (HIV)-Associated Neurocognitive Disorders in Recent Years and Associated Factors in a Large Cohort of Antiretroviral Therapy-Treated Individuals With HIV.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2023Article
- Anticholinergic and Sedative Medications Are Associated With Neurocognitive Performance of Well Treated People With Human Immunodeficiency Virus.Open forum infectious diseases · 2022Article
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Authors and funding
4 authors.
Funding
Abstract
backgroundAge-related comorbidities accumulate faster in people with HIV (PWH) than in those without HIV. We evaluated whether a validated multimorbidity scale, the Charlson index, predicted neurocognitive trajectories in PWH.
methodsScaled scores of a comprehensive neuropsychological battery were averaged across all visits. Multilevel modeling examined between- and within-person predictors of global neurocognition. At the between-person level, averaged Charlson scores were examined as a predictor of neurocognitive change rate, covarying for HIV disease characteristics. Within-persons, visit-specific Charlson index was used to predict fluctuations in global neurocognition at the same and next visit, covarying for disease measures.
resultsParticipants were 1195 PWH (mean baseline age: 43.0; SD: 9.7 years) followed for a mean of 7.1 years (range: 0.5-20.5). At the between-person level, more rapid neurocognitive worsening correlated with higher (worse) average Charlson scores (standardized β: -0.062; SE: 0.015; P = .001) and lower CD4 nadir (standardized β: 0.055; SE: 0.021; P = .011), but not viral suppression or average CD4+ lymphocytes (P > .05). At the within-person level, poorer visit-specific neurocognition was related to worse concurrent, but not preceding, Charlson scores (standardized β: -0.046; SE: 0.015; P = .003), detectable HIV viral load (standardized β: 0.018; SE: 0.006; P = .001), and higher CD4+ (standardized β: 0.043; SE: 0.009; P < .001).
conclusionsThe impact of comorbidities on neurocognitive decline exceeded that of HIV disease factors. Although correlative, the temporal relationships suggested that treatment of comorbidities might improve neurocognitive prognosis for PWH.
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