title: Latent toxoplasmosis is associated with neurocognitive impairment in young adults with and without chronic HIV infection.
abstract: We evaluated the impact of latent toxoplasmosis (LT) on neurocognitive (NC) and neurobehavioural functioning in young adults with and without chronic HIV infection, using a standardised NC test battery, self-reported Beck Depression Inventory, Frontal System Behavior Scale, MINI-International Neuropsychiatric Interview and risk-assessment battery. 194 young adults (median age 24years, 48.2% males) with chronic HIV infection (HIV+) since childhood and 51 HIV seronegative (HIV-) participants were included. HIV+ individuals had good current immunological status (median CD4: 479 cells/μl) despite a low CD4 nadir (median: 93 cells/μl). LT (positive anti-Toxoplasma IgG antibodies) was present in one third of participants. The impairment rates in the HIV- with and without Toxo were not significantly different (p=0.17). However, we observed an increasing trend (p<0.001) in impairment rates with HIV and LT status: HIV-/LT- (6.1%); HIV-/LT+ (22%), HIV+/LT- (31%), HIV+/LT+ (49%). In a multivariable analysis using the entire study group there were main effects on cognition for HIV and also for LT. Within the HIV+ group LT was associated with worse performance globally (p=0.006), in memory (p=0.009), speed of information processing (p=0.01), verbal (p=0.02) and learning (p=0.02) domains. LT was not associated with depressive symptoms, frontal systems dysfunction or risk behaviors in any of the groups. HIV participants with lower Toxoplasma antibody concentration had worse NC performance, with higher GDS values (p=0.03) and worse learning (p=0.002), memory (p=0.006), speed of information processing (p=0.01) T scores. Latent Toxoplasmosis may contribute to NC impairment in young adults, including those with and without chronic HIV infection.
authors.affiliation: "Dr. Victor Babes" Hospital for Infectious and Tropical Diseases, Bucharest, Romania. Electronic address: luminita.ene@spitalulbabes.ro.
authors.forename: L
authors.initials: L
authors.lastname: Ene
authors.affiliation: University of California San Diego, La Jolla, CA, USA.
authors.forename: T D
authors.initials: TD
authors.lastname: Marcotte
authors.affiliation: University of California San Diego, La Jolla, CA, USA.
authors.forename: A
authors.initials: A
authors.lastname: Umlauf
authors.affiliation: "Stefan S. Nicolau" Institute of Virology, Bucharest, Romania.
authors.forename: C
authors.initials: C
authors.lastname: Grancea
authors.affiliation: "Stefan S. Nicolau" Institute of Virology, Bucharest, Romania.
authors.forename: A
authors.initials: A
authors.lastname: Temereanca
authors.affiliation: University of California San Diego, La Jolla, CA, USA.
authors.forename: A
authors.initials: A
authors.lastname: Bharti
authors.affiliation: University of California San Diego, La Jolla, CA, USA.
authors.forename: C L
authors.initials: CL
authors.lastname: Achim
authors.affiliation: University of California San Diego, La Jolla, CA, USA.
authors.forename: S
authors.initials: S
authors.lastname: Letendre
authors.affiliation: "Stefan S. Nicolau" Institute of Virology, Bucharest, Romania.
authors.forename: S M
authors.initials: SM
authors.lastname: Ruta
mesh_terms: D000328:Adult; D002908:Chronic Disease; D003072:Cognition Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology*; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology*; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D014123:Toxoplasmosis / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology*; D055815:Young Adult
keywords: HIV; Latent toxoplasmosis; Neurocognitive impairment; Young adults