Apolipoprotein-E genotype and human immunodeficiency virus-associated neurocognitive disorder

The modulating effects of older age and disease severity

Stella E. Panos, Charles H. Hinkin, Elyse J. Singer, April D. Thames, Sapna M. Patel, Janet S. Sinsheimer, A. C. Del Re, Benjamin Gelman, Susan Morgello, David J. Moore, Andrew J. Levine

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Background: The apolipoprotein-E (APOE) ε4 allele is a risk factor for vascular dementia and Alzheimer's disease. Recent studies are equivocal with regards to whether or not the e4 allele confers increased risk for the development of human immunodeficiency virus (HIV)-associated neurocognitive disorder (HAND), but suggest that age and/or disease severity may be modulating factors. The aim of this study was to assess the interactions and contributions of APOE genotype, age, and HIV disease severity as risk factors for HAND in HIV-infected adults. Methods: Participants were 259 HIV-positive individuals who underwent APOE genotyping, a standardized neurological evaluation, a comprehensive neuropsychological evaluation, and laboratory testing. Results: Older ε4 carriers showed a higher frequency of HAND compared with age-matched non-ε4 carriers. Analysis by discrete neurocognitive domain revealed that advanced age modulated the effect of the ε4 allele, such that older ε4 allele carriers showed reduced executive functioning and information processing speed. Exploratory analyses assessing the relationship between e4 and disease severity in the overall sample revealed that disease severity modulated the effect of the ε4 allele on cognition. Lower absolute CD4+ cell count among ε4 allele carriers was associated with poorer working memory ability. Conclusion: Advancing age and degree of immunosuppression may influence the association between APOE ε4 allele status and HAND. These two factors need to be taken into account in future research.

Original languageEnglish (US)
Pages (from-to)11-22
Number of pages12
JournalNeurobehavioral HIV Medicine
Volume5
Issue number1
DOIs
StatePublished - 2013

Fingerprint

Apolipoproteins E
Alleles
Genotype
HIV
Apolipoprotein E4
Vascular Dementia
Aptitude
Virus Diseases
CD4 Lymphocyte Count
Neurocognitive Disorders
Automatic Data Processing
Vascular Diseases
Short-Term Memory
Immunosuppression
Cognition
Alzheimer Disease

Keywords

  • Aging
  • Apolipoprotein-E
  • Human immunodeficiency virus
  • Neurocognition

ASJC Scopus subject areas

  • Infectious Diseases
  • Dermatology
  • Behavioral Neuroscience
  • Psychiatry and Mental health

Cite this

Apolipoprotein-E genotype and human immunodeficiency virus-associated neurocognitive disorder : The modulating effects of older age and disease severity. / Panos, Stella E.; Hinkin, Charles H.; Singer, Elyse J.; Thames, April D.; Patel, Sapna M.; Sinsheimer, Janet S.; Del Re, A. C.; Gelman, Benjamin; Morgello, Susan; Moore, David J.; Levine, Andrew J.

In: Neurobehavioral HIV Medicine, Vol. 5, No. 1, 2013, p. 11-22.

Research output: Contribution to journalArticle

Panos, SE, Hinkin, CH, Singer, EJ, Thames, AD, Patel, SM, Sinsheimer, JS, Del Re, AC, Gelman, B, Morgello, S, Moore, DJ & Levine, AJ 2013, 'Apolipoprotein-E genotype and human immunodeficiency virus-associated neurocognitive disorder: The modulating effects of older age and disease severity', Neurobehavioral HIV Medicine, vol. 5, no. 1, pp. 11-22. https://doi.org/10.2147/NBHIV.S39573
Panos, Stella E. ; Hinkin, Charles H. ; Singer, Elyse J. ; Thames, April D. ; Patel, Sapna M. ; Sinsheimer, Janet S. ; Del Re, A. C. ; Gelman, Benjamin ; Morgello, Susan ; Moore, David J. ; Levine, Andrew J. / Apolipoprotein-E genotype and human immunodeficiency virus-associated neurocognitive disorder : The modulating effects of older age and disease severity. In: Neurobehavioral HIV Medicine. 2013 ; Vol. 5, No. 1. pp. 11-22.
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