title: Select neurocognitive impairment in HIV-infected women: associations with HIV viral load, hepatitis C virus, and depression, but not leukocyte telomere length.
abstract: BACKGROUND
  Through implementation of combination antiretroviral therapy (cART) remarkable gains have been achieved in the management of HIV infection; nonetheless, the neurocognitive consequences of infection remain a pivotal concern in the cART era. Research has often employed norm-referenced neuropsychological scores, derived from healthy populations (excluding many seronegative individuals at high risk for HIV infection), to characterize impairments in predominately male HIV-infected populations.
  
  
  METHODS
  Using matched-group methodology, we assessed 81 HIV-seropositive (HIV+) women with established neuropsychological measures validated for detection of HIV-related impairments, as well as additional detailed tests of executive function and decision-making from the Cambridge Neuropsychological Test Automated Battery (CANTAB).
  
  
  RESULTS
  On validated tests, the HIV+ women exhibited impairments that were limited to significantly slower information processing speed when compared with 45 HIV-seronegative (HIV-) women with very similar demographic backgrounds and illness comorbidities. Additionally, select executive impairments in shifting attention (i.e., reversal learning) and in decision-making quality were revealed in HIV+ participants. Modifiers of neurocognition in HIV-infected women included detectable HIV plasma viral load, active hepatitis C virus co-infection, and self-reported depression symptoms. In contrast, leukocyte telomere length (LTL), a marker of cellular aging, did not significantly differ between HIV+ and HIV- women, nor was LTL associated with overall neurocognition in the HIV+ group.
  
  
  CONCLUSIONS
  The findings suggest that well-managed HIV infection may entail a more circumscribed neurocognitive deficit pattern than that reported in many norm-referenced studies, and that common comorbidities make a secondary contribution to HIV-related neurocognitive impairments.
authors.affiliation: Department of Psychology, Simon Fraser University, Burnaby, British Columbia, Canada; British Columbia Mental Health and Addictions Research Institute, Vancouver, British Columbia, Canada.
authors.forename: Chantelle J
authors.initials: CJ
authors.lastname: Giesbrecht
authors.affiliation: Department of Psychology, Simon Fraser University, Burnaby, British Columbia, Canada; British Columbia Mental Health and Addictions Research Institute, Vancouver, British Columbia, Canada.
authors.forename: Allen E
authors.initials: AE
authors.lastname: Thornton
authors.affiliation: Oak Tree Clinic, BC Women's Hospital, Vancouver, British Columbia, Canada; CIHR Emerging Team in HIV Therapy and Aging (CARMA), Vancouver, British Columbia, Canada.
authors.forename: Clare
authors.initials: C
authors.lastname: Hall-Patch
authors.affiliation: Oak Tree Clinic, BC Women's Hospital, Vancouver, British Columbia, Canada; CIHR Emerging Team in HIV Therapy and Aging (CARMA), Vancouver, British Columbia, Canada.
authors.forename: Evelyn J
authors.initials: EJ
authors.lastname: Maan
authors.affiliation: CIHR Emerging Team in HIV Therapy and Aging (CARMA), Vancouver, British Columbia, Canada; Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada; Women's Health Research Institute, Vancouver, British Columbia, Canada.
authors.forename: Hélène C F
authors.initials: HC
authors.lastname: Côté
authors.affiliation: Oak Tree Clinic, BC Women's Hospital, Vancouver, British Columbia, Canada; CIHR Emerging Team in HIV Therapy and Aging (CARMA), Vancouver, British Columbia, Canada; Women's Health Research Institute, Vancouver, British Columbia, Canada; Department of Obstetrics & Gynecology, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Deborah M
authors.initials: DM
authors.lastname: Money
authors.affiliation: Oak Tree Clinic, BC Women's Hospital, Vancouver, British Columbia, Canada; CIHR Emerging Team in HIV Therapy and Aging (CARMA), Vancouver, British Columbia, Canada; Women's Health Research Institute, Vancouver, British Columbia, Canada; Division of Infectious Disease, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Melanie
authors.initials: M
authors.lastname: Murray
authors.affiliation: Oak Tree Clinic, BC Women's Hospital, Vancouver, British Columbia, Canada; CIHR Emerging Team in HIV Therapy and Aging (CARMA), Vancouver, British Columbia, Canada; Women's Health Research Institute, Vancouver, British Columbia, Canada; Division of Infectious Disease, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Neora
authors.initials: N
authors.lastname: Pick
mesh_terms: D000328:Adult; D003072:Cognition Disorders / Q000150:complications* / Q000821:virology; D003710:Demography; D003863:Depression / Q000150:complications* / Q000821:virology; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000821:virology; D006679:HIV Seropositivity / Q000150:complications / Q000821:virology; D016174:Hepacivirus / Q000502:physiology*; D006801:Humans; D007962:Leukocytes / Q000378:metabolism / Q000473:pathology*; D008875:Middle Aged; D012015:Reference Standards; D016615:Telomere / Q000378:metabolism*; D019562:Viral Load