Determinants of cognitive health in Indonesian HIV patients beginning antiretroviral therapy

Estiasari, Riwanti; Aryanto, Ibnu; Lee, Silvia; Pramana, Setia; Djauzi, Samsuridjal; Price, Patricia

doi:10.1007/s13365-019-00787-2

Cited by 14 publications

(26 citation statements)

References 21 publications

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“…The CMV burden measured by using CMV IE level after ART admission was also correlated with right CIMT 10 . We also found that CMV antibody level was inversely correlated with the Z score of cognitive result before ART admission 11 .…”

Section: Introductionsupporting

confidence: 55%

“…A trained dentist will assess periodontitis using CPI, which was modified by the World Health Organization (WHO). This assessment uses a 0.5 mm ball tip periodontal probe with black band markers at 3.5, 5.5, 8.5, and 11.5 mm, and involve 10 teeth (17,16,11,26,27,37,36,31,46, and 47). The score ranges from 0 for healthy periodontal to score 4 for periodontal pocket ≥6 mm 40,41 .…”

Section: Data Collection and Managementmentioning

confidence: 99%

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Effect of atorvastatin on subclinical atherosclerosis in virally-suppressed HIV-infected patients with CMV seropositivity: a randomized double-blind placebo-controlled trial

et al. 2021

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Background: Persistent immune activation and inflammation in HIV-infection are linked to excess cardiovascular risk and other non-communicable diseases. Periodic asymptomatic CMV-reactivity in HIV infected patients over a lifetime may contribute to non-AIDS defining morbidity. Despite undetectable levels of HIV and CMV, these patients continue to have increased levels of biomarkers and immune activations. Statin administration is thought to reduce subclinical atherosclerosis by decreasing LDL-C levels. It may also add beneficial effects against CMV infection. Methods: We are conducting a double-blind placebo-controlled trial in which patients are randomized to receive either atorvastatin or placebo with a ratio of 1:1. This trial aims to study the effect of atorvastatin in statin-naive virally-suppressed HIV-infected patients with stable ART and CMV seropositivity on carotid intima media thickness (CIMT), tool that evaluates subclinical atherosclerosis. The study recruits 80 patients at HIV integrated care unit of Cipto Mangunkusumo hospital. All eligible subjects have CIMT evaluation as primary outcome, along with flow mediated vasodilatation (FMD), liver fibrosis and steatosis evaluation, fasting lipid, neurocognitive test, community periodontal index (CPI), and residual immune activation as secondary outcomes in 48 weeks. Ethics and dissemination: This study has received an ethical approval from Health Research Ethics Commitee–Universitas Indonesia and Cipto Mangunkusumo Hospital. Before joining the study, all participants fill in an informed consent form. At the end of study analysis, the trial results will be published and disseminated in peer-reviewed journals. Discussion: The main purpose of our study is to evaluate the effect of atorvastatin administration on CIMT changes in statin naïve virally suppressed HIV-infected patients with stable ART and CMV seropositivity Registration: ClinicalTrials.gov ID NCT04101136; registered on 24 September 2019.

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Section: Introductionsupporting

confidence: 55%

Section: Data Collection and Managementmentioning

confidence: 99%

Effect of atorvastatin on subclinical atherosclerosis in virally-suppressed HIV-infected patients with CMV seropositivity: a randomized double-blind placebo-controlled trial

et al. 2021

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“…Indeed, cognitive impairment was found to be more common among frail (59%) compared to non-frail (34%) individuals, both of which predict poor outcomes [55,56]. In Indonesia, the prevalence of HAND was 51% among treatment-naïve PLHIV but cognitive function improved and stabilized after 6 months of ART [57,58]. Nevertheless, presence of dementia and cognitive function was not assessed in this study, which we acknowledge as an important limitation of the study.…”

Section: Prevalence Of Frailty and Associated Factorsmentioning

confidence: 99%

Frailty among HIV-1 Infected Adults under Antiretroviral Therapy in Indonesia

Wulunggono

Yunihastuti

Shatri

et al. 2019

CHR

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Background: Increasing age of HIV-1 infected population brought about the risk of frailty as comorbidity, whose prevalence is higher in low and middle-income countries (LMICs). Indonesia as an LMIC also bears a major burden of HIV-1 epidemic with a similarly aging population, but the prevalence of frailty and its predictors are unknown. Objectives: To identify the prevalence of frailty and analyze its associated factors, among HIV-1 infected adults under antiretroviral therapy in Indonesia. Methods: A cross-sectional study was conducted among HIV-infected individuals with inclusion criteria of age ≥30 years old and underwent ART for at least 6 months. The main assessment was done using Fried’s frailty phenotype score, which categorizes subjects into non-frail, pre-frail, or frail. Factors associated with frailty were characterized and multiple logistic regression analysis was performed. Results: A total of 164 subjects were recruited; male subjects were 118 (72%), the median age was 40.5 years old, and the median CD4 nadir was 53 cells/μl. Frailty was identified among 90 (54.9%) subjects with 84 (51.2%) identified as pre-frail and 6 (3.7%) as frail, with dominant frailty phenotype was weakness in grip strength. The multivariate model showed that depression was the only factor significantly correlated with pre-frailty and frailty (OR 2.14; 95% CI 1.04-4.43, p=0.036). Conclusion: Frailty is a common occurrence among HIV-infected patients under ART, with depression as an independent predictive factor.

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“…Levels of CMV reactive antibodies were determined using in-house ELISAs recognizing a lysate of fibroblasts infected with HCMV AD169 ("HCMV lysate"), gB or IE-1 protein. The cut-off defining seropositivity was 3600 AU/mL based on HCMV lysate [14,15]. This cut off was determined in relation to samples from individuals deemed to be seronegative using the ARCHITECT CMV IgG assay.…”

Section: Resultsmentioning

confidence: 99%

Challenging the Conventional Interpretation of HCMV Seronegativity

Waters

Lee

Irish

et al. 2021

Preprint

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The majority of adults in the world (around 83%) carry antibodies reactive with HCMV and are thought to retain inactive or latent infections lifelong. The virus is transmitted via saliva so infection events are likely to be common. Indeed it is hard to imagine a life without exposure to HCMV. From 45 seronegative individuals (13 renal transplant recipients, 32 healthy adults), we present seven cases who had detectable HCMV DNA in their blood and/or saliva, or a CMV-encoded homologue of IL-10 (vIL-10) in their plasma. One case displayed NK cells characteristic of CMV infection, and HCMV DNA became undetectable. In other cases, the infection may persist with seroconversion blocked by vIL-10. Future research should seek mechanisms that can prevent an individual from seroconverting despite a persistent HCMV infection, as HCMV vaccines may not work well in such people.

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Determinants of cognitive health in Indonesian HIV patients beginning antiretroviral therapy

Cited by 14 publications

References 21 publications

Effect of atorvastatin on subclinical atherosclerosis in virally-suppressed HIV-infected patients with CMV seropositivity: a randomized double-blind placebo-controlled trial

Effect of atorvastatin on subclinical atherosclerosis in virally-suppressed HIV-infected patients with CMV seropositivity: a randomized double-blind placebo-controlled trial

Frailty among HIV-1 Infected Adults under Antiretroviral Therapy in Indonesia

Challenging the Conventional Interpretation of HCMV Seronegativity

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