No Association Between Human Immunodeficiency Virus Infections And Dementia: A Nationwide Cohort Study In Taiwan

Overview

Journal Neuropsychiatr Dis Treat

Publisher Dove Medical Press

Specialty Psychiatry

Date 2019 Dec 10

PMID 31814723

Citations 10

Authors

Chuan-Chi Yang

Wu-Chien Chien

Chi-Hsiang Chung

Yia-Ping Liu

Chin-Bin Yeh

Kuang-Huei Chen

Szu-Nian Yang

Hsin-An Chang

Yu-Chen Kao

Wan-Chun Lu

Nian-Sheng Tzeng

Affiliations

Soon will be listed here.

Abstract

Background: The associations between the human immunodeficiency virus (HIV) and dementias are as yet to be studied in Taiwan. The aim of this study is to clarify as to whether HIV infections are associated with the risk of dementia.

Methods: A total of 1,261 HIV-infected patients and 3,783 controls (1:3) matched for age and sex were selected between January 1 and December 31, 2000 from Taiwan's National Health Insurance Research Database (NHIRD). Fine and Gray's survival analysis (competing with mortality) analyzed the risk of dementias during the 15-year follow up. The association between the highly active antiretroviral therapy (HAART) and dementia was analyzed by stratifying the HAART status among the HIV subjects.

Results: During the follow-up period, 25 in the HIV group (N= 1,261) and 227 in the control group (N= 3,783) developed dementia (656.25 vs 913.15 per 100,000 person-years). Fine and Gray's survival analysis revealed that the HIV patients were not associated with an increased risk of dementia, with the adjusted hazard ratio (HR) as 0.852 (95% confidence interval [CI]: 0.189-2.886, =0.415) after adjusting for sex, age, comorbidities, geographical region, and the urbanization level of residence. There was no significant difference between the two groups of HIV-infected patients with or without HAART in the risk of dementia.

Conclusion: This study found that HIV infections, either with or without HAART, were not associated with increased diagnoses of neurodegenerative dementias in patients older than 50 in Taiwan.

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References

Cheng C, Kao Y, Lin S, Lee C, Lai M . Validation of the National Health Insurance Research Database with ischemic stroke cases in Taiwan. Pharmacoepidemiol Drug Saf. 2011; 20(3):236-42. DOI: 10.1002/pds.2087. View

Alizon S, Hurford A, Mideo N, van Baalen M . Virulence evolution and the trade-off hypothesis: history, current state of affairs and the future. J Evol Biol. 2009; 22(2):245-59. DOI: 10.1111/j.1420-9101.2008.01658.x. View

Chen M, Su T, Chen T, Cheng J, Wei H, Bai Y . Identification of psychiatric disorders among human immunodeficiency virus-infected individuals in Taiwan, a nine-year nationwide population-based study. AIDS Care. 2012; 24(12):1543-9. DOI: 10.1080/09540121.2012.672716. View

Chiao S, Rosen H, Nicolas K, Wendelken L, Alcantar O, Rankin K . Deficits in self-awareness impact the diagnosis of asymptomatic neurocognitive impairment in HIV. AIDS Res Hum Retroviruses. 2013; 29(6):949-56. PMC: 3653396. DOI: 10.1089/AID.2012.0229. View

Heaton R, Franklin D, Ellis R, McCutchan J, Letendre S, LeBlanc S . HIV-associated neurocognitive disorders before and during the era of combination antiretroviral therapy: differences in rates, nature, and predictors. J Neurovirol. 2010; 17(1):3-16. PMC: 3032197. DOI: 10.1007/s13365-010-0006-1. View

Sacktor N, Skolasky R, Seaberg E, Munro C, Becker J, Martin E . Prevalence of HIV-associated neurocognitive disorders in the Multicenter AIDS Cohort Study. Neurology. 2016; 86(4):334-40. PMC: 4776086. DOI: 10.1212/WNL.0000000000002277. View

de Groot V, Beckerman H, Lankhorst G, Bouter L . How to measure comorbidity. a critical review of available methods. J Clin Epidemiol. 2003; 56(3):221-9. DOI: 10.1016/s0895-4356(02)00585-1. View

Schouten J, Cinque P, Gisslen M, Reiss P, Portegies P . HIV-1 infection and cognitive impairment in the cART era: a review. AIDS. 2010; 25(5):561-75. DOI: 10.1097/QAD.0b013e3283437f9a. View

Guaraldi G, Prakash M, Moecklinghoff C, Stellbrink H . Morbidity in older HIV-infected patients: impact of long-term antiretroviral use. AIDS Rev. 2014; 16(2):75-89. View

10.

Xu J, Ikezu T . The comorbidity of HIV-associated neurocognitive disorders and Alzheimer's disease: a foreseeable medical challenge in post-HAART era. J Neuroimmune Pharmacol. 2008; 4(2):200-12. PMC: 2682636. DOI: 10.1007/s11481-008-9136-0. View

11.

Theys K, Libin P, Pineda-Pena A, Nowe A, Vandamme A, Abecasis A . The impact of HIV-1 within-host evolution on transmission dynamics. Curr Opin Virol. 2017; 28:92-101. DOI: 10.1016/j.coviro.2017.12.001. View

12.

Zayyad Z, Spudich S . Neuropathogenesis of HIV: from initial neuroinvasion to HIV-associated neurocognitive disorder (HAND). Curr HIV/AIDS Rep. 2015; 12(1):16-24. PMC: 4741099. DOI: 10.1007/s11904-014-0255-3. View

13.

Mills E, Barnighausen T, Negin J . HIV and aging--preparing for the challenges ahead. N Engl J Med. 2012; 366(14):1270-3. DOI: 10.1056/NEJMp1113643. View

14.

Vivithanaporn P, Heo G, Gamble J, Krentz H, Hoke A, Gill M . Neurologic disease burden in treated HIV/AIDS predicts survival: a population-based study. Neurology. 2010; 75(13):1150-8. PMC: 3013488. DOI: 10.1212/WNL.0b013e3181f4d5bb. View

15.

Chang C, Chen W, Liou Y, Ke C, Lee H, Huang H . Increased risk of major depression in the three years following a femoral neck fracture--a national population-based follow-up study. PLoS One. 2014; 9(3):e89867. PMC: 3953077. DOI: 10.1371/journal.pone.0089867. View

16.

Antinori A, Arendt G, Becker J, Brew B, Byrd D, Cherner M . Updated research nosology for HIV-associated neurocognitive disorders. Neurology. 2007; 69(18):1789-99. PMC: 4472366. DOI: 10.1212/01.WNL.0000287431.88658.8b. View

17.

Wang H, Chen J, Huang S, Yeh H, Mao W, Chang H . Forensic Evaluations for Offenders With Dementia in Taiwan's Criminal Courts. J Am Acad Psychiatry Law. 2018; 46(1):45-51. View

18.

Tsai Y, Chen Y, Hsieh C, Ko W, Ko N . Incidence of Neurological Disorders Among HIV-Infected Individuals With Universal Health Care in Taiwan From 2000 to 2010. J Acquir Immune Defic Syndr. 2017; 75(5):509-516. DOI: 10.1097/QAI.0000000000001448. View

19.

Cheng C, Chien H, Lee C, Lin S, Kao Yang Y . Validity of in-hospital mortality data among patients with acute myocardial infarction or stroke in National Health Insurance Research Database in Taiwan. Int J Cardiol. 2015; 201:96-101. DOI: 10.1016/j.ijcard.2015.07.075. View

20.

Lin C, Lai M, Syu C, Chang S, Tseng F . Accuracy of diabetes diagnosis in health insurance claims data in Taiwan. J Formos Med Assoc. 2005; 104(3):157-63. View