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Methamphetamine dependence increases risk of neuropsychological impairment in HIV infected persons

Published online by Cambridge University Press:  06 February 2004

JULIE D. RIPPETH
Affiliation:
Department of Psychiatry, University of California, San Diego School of Medicine, San Diego, California
ROBERT K. HEATON
Affiliation:
Department of Psychiatry, University of California, San Diego School of Medicine, San Diego, California San Diego State University and University of California, San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California
CATHERINE L. CAREY
Affiliation:
San Diego State University and University of California, San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California
THOMAS D. MARCOTTE
Affiliation:
Department of Psychiatry, University of California, San Diego School of Medicine, San Diego, California San Diego State University and University of California, San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California
DAVID J. MOORE
Affiliation:
San Diego State University and University of California, San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California
RAUL GONZALEZ
Affiliation:
San Diego State University and University of California, San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California
TANYA WOLFSON
Affiliation:
Department of Psychiatry, University of California, San Diego School of Medicine, San Diego, California
IGOR GRANT
Affiliation:
Department of Psychiatry, University of California, San Diego School of Medicine, San Diego, California San Diego State University and University of California, San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California Veterans Affairs San Diego Healthcare System
THE HNRC GROUP
Affiliation:
Department of Psychiatry, University of California, San Diego School of Medicine, San Diego, California

Abstract

Both HIV infection and methamphetamine dependence can be associated with brain dysfunction. Little is known, however, about the cognitive effects of concurrent HIV infection and methamphetamine dependence. The present study included 200 participants in 4 groups: HIV infected/methamphetamine dependent (HIV+/METH+), HIV negative/methamphetamine dependent (HIV−/METH+), HIV infected/methamphetamine nondependent (HIV+/METH−), and HIV negative/methamphetamine nondependent (HIV−/METH−). Study groups were comparable for age, education, and ethnicity, although the HIV−/METH− group had significantly more females. A comprehensive, demographically corrected neuropsychological battery was administered yielding a global performance score and scores for seven neurobehavioral domains. Rates of neuropsychological impairment were determined by cutoff scores derived from performances of a separate control group and validated with larger samples of HIV+ and HIV− participants from an independent cohort. Rates of global neuropsychological impairment were higher in the HIV+/METH+ (58%), HIV−/METH+ (40%) and HIV+/METH− (38%) groups compared to the HIV−/METH− (18%) group. Nonparametric analyses revealed a significant monotonic trend for global cognitive status across groups, with least impairment in the control group and highest prevalence of impairment in the group with concurrent HIV infection and methamphetamine dependence. The results indicate that HIV infection and methamphetamine dependence are each associated with neuropsychological deficits, and suggest that these factors in combination are associated with additive deleterious cognitive effects. This additivity may reflect common pathways to neural injury involving both cytotoxic and apoptotic mechanisms. (JINS, 2004, 10, 1–14.)Note: Dr. Erin D. Bigler served as action editor during the course of this review.

Type
Research Article
Copyright
© 2004 The International Neuropsychological Society

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