Associations of cigarette smoking with viral immune and cognitive function in human immunodeficiency virus–seropositive women

Abstract

Cigarette smoking alters the immune system and may improve cognitive deficits in neuropsychiatric disorders. Smoking prevalence is high in human immunodeficiency virus (HIV)-infected patients; however, its effect on HIV-associated cognitive impairment remains unknown in the era of antiretroviral treatment. The authors examined associations of smoking with viral immune profile and cognitive function in a cohort of HIV-seropositive women. This observational cross-sectional study included 56 women (36 HIV-seropositive and 20 HIV-seronegative) surveyed with a tobacco questionnaire: the Fagerström Test for Nicotine Dependency. Viral immune status was obtained 6 to 12 months before questioned. Neurocognitive testing (NP) assessed verbal memory, frontal/executive function, psychomotor speed, and motor speed. A reference group of HIV-seronegative women was used to calculate standardized z-scores. Cognitive impairment was classified using a modified American Academy of Neurology criteria, adding an asymptomatic group based on NP tests. Statistics included parametric and nonparametric tests. HIV-seropositive Address correspondence to Valerie Wojna, MD, NeuroAIDS Program, PO Box 365067, San Juan, Puerto Rico 00936-5067. vwojna@rcm.upr.edu. Full terms and conditions of use: http://www.informaworld.com/terms-and-conditions-of-access.pdf This article may be used for research, teaching and private study purposes. Any substantial or systematic reproduction, re-distribution, re-selling, loan or sub-licensing, systematic supply or distribution in any form to anyone is expressly forbidden. Publisher's Disclaimer: The publisher does not give any warranty express or implied or make any representation that the contents will be complete or accurate or up to date. The accuracy of any instructions, formulae and drug doses should be independently verified with primary sources. The publisher shall not be liable for any loss, actions, claims, proceedings, demand or costs or damages whatsoever or howsoever caused arising directly or indirectly in connection with or arising out of the use of this material. HHS Public AccessAuthor manuscript J Neurovirol. Author manuscript; available in PMC 2016 July 27. Author Manuscript Author ManuscriptAuthor ManuscriptAuthor Manuscript women were more likely to report a history of smoking (P = 0.028). Among them, current smoking correlated with higher plasma viral load (P = 0.048), and history of smoking correlated with lower CD4 cell count (P = 0.027). The authors observed no associations between cognitive impairment and either current or past history of smoking and no differences in neurocognitive domain scores between HIV-seropositive and -seronegative women or between those with and without a history of smoking. However, restricting analysis to HIV-seropositives showed a significant better performance on the frontal/executive domain in those with history of smoking. In summary, history of smoking correlated with better frontal/executive cognitive domain performance in HIV-seropositive women a...

Cigarette smoke and nicotine effects on brain proinflammatory responses and behavioral and motor function in HIV-1 transgenic rats

“…These effects could potentially result in nicotine inducing an overall enhancement of inflammatory responses, which could exacerbate the nervous system damage that can occur in HIV-infected individuals. Such effects would be consistent with studies that show that smoking has deleterious effects on cognitive functioning among HIV-infected individuals (Chang et al 2017; Harrison et al 2017; Wojna et al 2007), although the specificity of such effects has been questioned (Bryant et al 2013). …”

“…HIV-infected smokers also have a higher mortality than infected nonsmokers and HIV-negative individuals (Helleberg et al 2013), suggesting likely direct effects from smoking and interactions between smoking and HIV-1 infection on mortality. Also, although data may be conflicting as to whether cigarette smoking can increase progression to AIDS (Galai et al 1997; Nieman et al 1993), smoking has been associated with an increased HIV plasma viral load (Wojna et al 2007), and an increased risk of developing neurocognitive impairment (Harrison et al 2017; Wojna et al 2007). Approximately 40% of HIV-positive individuals are cigarette smokers (Lifson and Lando 2012), which is more than twice the prevalence of smoking among adults in the general population (Jamal et al 2016).…”

Tobacco smoking effect on HIV-1 pathogenesis: role of cytochrome P450 isozymes

“…Limited studies have addressed the effects of smoking on cognitive function and neurological disorders in the HIV-1-infected individuals with controversial findings [36]. Of relevance, it has been reported that chronic nicotine exposure can lead to the disruption of the blood–brain barrier (BBB) integrity, which may enhance the exposure to HIV-1-infected monocytes, tobacco constituents and antiretroviral drugs [37].…”

“…The exposure of these agents to CNS may exacerbate neuroAIDS and neurodegenerative diseases [37]. Another report from an observational cross-sectional study conducted in 56 women (36 HIV-1-infected and 20 non-HIV-1- infected) suggests that there is no correlation between smoking and cognitive dysfunction [36] in the HIV-1-infected population. Collectively, the available evidence suggests that there is an increase in smoking-mediated HIV-1 pathogenesis among individuals with HIV-1/AIDS and patients may benefit from the development of novel therapeutic agents and/or drug dose adjustments that can be used to treat HIV-1-infected smokers effectively.…”

Enhanced Nicotine Metabolism in HIV-1–Positive Smokers Compared with HIV-Negative Smokers: Simultaneous Determination of Nicotine and its Four Metabolites in Their Plasma Using a Simple and Sensitive Electrospray Ionization Liquid Chromatography–Tandem Mass Spectrometry Technique

“…Since nicotine exposure has been shown to disrupt the blood-brain barrier (Manda et al, 2010), HIV-1-infected monocytes/macrophages can infiltrate the brain and infect microglia, astrocytes, and perivascular macrophages (Kedzierska and Crowe, 2002;Montaner et al, 2006). In addition, smoking has been shown to decrease the response to antiretroviral therapy that enhances the risk of viral replication (Feldman et al, 2006;Wojna et al, 2007).…”