Mini-review: Elucidating the psychological, physical, and sex-based interactions between HIV infection and stress

Stadtler, Hannah; Shaw, Gladys A.; Neigh, Gretchen N.

doi:10.1016/j.neulet.2021.135698

Cited by 15 publications

(9 citation statements)

References 167 publications

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“…In line with these hypotheses, almost all CNS-AEs reported in the present study resolved after a one-year follow-up. Moreover, none of the features that we examined seemed predictive of CNS-AE non-resolution, except for older age, which might also be interpreted as an independent risk factor for neurocognitive disorders in ageing PLWH independently from ART exposure [ 56 , 57 , 58 ]. The lack of recovery of neuropsychiatric symptoms after discontinuation of the drug, however, might also be interpreted as a lack of an actual correlation with the drug rather than as a sign of persisting damage.…”

Section: Discussionmentioning

confidence: 99%

Reversibility of Central Nervous System Adverse Events in Course of Art

Taramasso

Orofino

Ricci

et al. 2022

Viruses

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The purpose of this study is to evaluate the frequency of central nervous system adverse events (CNS-AE) on dolutegravir (DTG) and non-DTG containing ART, and their reversibility, in the observational prospective SCOLTA cohort. Factors associated with CNS-AE were estimated using a Cox proportional-hazards model. 4939 people living with HIV (PLWH) were enrolled in DTG (n = 1179) and non-DTG (n = 3760) cohorts. Sixty-six SNC-AE leading to ART discontinuation were reported, 39/1179 (3.3%) in DTG and 27/3760 (0.7%) in non-DTG cohort. PLWH naïve to ART, with higher CD4 + T count and with psychiatric disorders were more likely to develop a CNS-AE. The risk was lower in non-DTG than DTG-cohort (aHR 0.33, 95% CI 0.19–0.55, p < 0.0001). One-year follow-up was available for 63/66 PLWH with CNS-AE. AE resolution was reported in 35/39 and 23/24 cases in DTG and non-DTG cohorts, respectively. The probability of AE reversibility was not different based on ART class, sex, ethnicity, CDC stage, or baseline psychiatric disorder. At the same time, a lower rate of event resolution was found in PLWH older than 50 years (p = 0.017). In conclusion, CNS-AE leading to ART discontinuation was more frequent in DTG than non-DTG treated PLWH. Most CNS-AE resolved after ART switch, similarly in both DTG and non-DTG cohorts.

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Section: Discussionmentioning

confidence: 99%

Reversibility of Central Nervous System Adverse Events in Course of Art

Taramasso

Orofino

Ricci

et al. 2022

Viruses

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“…Current smoking was also excluded at selection, but due to additions to the data after the sample was drawn, 4 people were in fact current smokers. Men were selected as they represent the largest group and the association between inflammation and cognition could vary by sex [ 16 , 17 ]. Blood collection was performed in the morning in fasting participants.…”

Section: Methodsmentioning

confidence: 99%

Translocation of bacterial LPS is associated with self-reported cognitive abilities in men living with HIV receiving antiretroviral therapy

et al. 2023

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Background Gut damage allows translocation of bacterial lipopolysaccharide (LPS) and fungal β-D-glucan (BDG) into the blood. This microbial translocation contributes to systemic inflammation and risk of non-AIDS comorbidities in people living with HIV, including those receiving antiretroviral therapy (ART). We assessed whether markers of gut damage and microbial translocation were associated with cognition in ART-treated PLWH. Methods Eighty ART-treated men living with HIV from the Positive Brain Health Now Canadian cohort were included. Brief cognitive ability measure (B-CAM) and 20-item patient deficit questionnaire (PDQ) were administered to all participants. Three groups were selected based on their B-CAM levels. We excluded participants who received proton pump inhibitors or antiacids in the past 3 months. Cannabis users were also excluded. Plasma levels of intestinal fatty acid binding protein (I-FABP), regenerating islet-derived protein 3 α (REG3α), and lipopolysaccharides (LPS = were quantified by ELISA, while 1–3-β-D-glucan BDG) levels were assessed using the Fungitell assay. Univariable, multivariable, and splines analyses were performed. Results Plasma levels of I-FABP, REG3α, LPS and BDG were not different between groups of low, intermediate and high B-CAM levels. However, LPS and REG3α levels were higher in participants with PDQ higher than the median. Multivariable analyses showed that LPS association with PDQ, but not B-CAM, was independent of age and level of education. I-FABP, REG3α, and BDG levels were not associated with B-CAM nor PDQ levels in multivariable analyses. Conclusion In this well characterized cohort of ART-treated men living with HIV, bacterial but not fungal translocation was associated with presence of cognitive difficulties. These results need replication in larger samples.

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“…24 (D) SDOH influence in early life and over the life course shapes HIV treatment outcomes and disease progression. 29,125,126 (E) The impact of SDOH on HIV outcomes includes biological mechanisms of influence, 60,67-69 including inflammatory [127][128][129][130][131][132][133] and neural 69,[131][132][133] mechanisms. (F) SDOH shape HIV outcomes for several generations through three types of intergenerational influence.…”

Section: Unjust Social Processes Shape Sdoh Mechanisms To Produce Hea...mentioning

confidence: 99%

Conceptualizing the Mechanisms of Social Determinants of Health: A Heuristic Framework to Inform Future Directions for Mitigation

2023

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A large body of scientific work examines the mechanisms through which social determinants of health (SDOH) shape health inequities. However, the nuances described in the literature are infrequently reflected in the applied frameworks that inform health policy and programming. We synthesize extant SDOH research into a heuristic framework that provides policymakers, practitioners, and researchers with a customizable template for conceptualizing and operationalizing key mechanisms that represent intervention opportunities for mitigating the impact of harmful SDOH. In light of scarce existing SDOH mitigation strategies, the framework addresses an important research‐to‐practice translation gap and missed opportunity for advancing health equity. Context The reduction of health inequities is a broad and interdisciplinary endeavor with implications for policy, research, and practice. Health inequities are most often understood as associated with the social determinants of health (SDOH). However, policy and programmatic frameworks for mitigation often rely on broad SDOH domains, without sufficient attention to the operating mechanisms, and effective SDOH mitigation strategies remain scarce. To expand the cadre of effective SDOH mitigation strategies, a practical, heuristic framework for policymakers, practitioners, and researchers is needed that serves as a roadmap for conceptualizing and targeting the key mechanisms of SDOH influence. Methods We conduct a critical review of the extant conceptual and empirical SDOH literature to identify unifying principles of SDOH mechanisms and to synthesize an integrated framework for conceptualizing such mechanisms. Findings We highlight eight unifying principles of SDOH mechanisms that emerge from landmark SDOH research. Building on these principles, we introduce and apply a conceptual model that synthesizes key SDOH mechanisms into one organizing, heuristic framework that provides policymakers, practitioners, and researchers with a customizable template for conceptualizing and operationalizing the key SDOH mechanisms that represent intervention opportunities to maximize potential impact for mitigating a given health inequity. Conclusions Our synthesis of the extant SDOH research into a heuristic framework addresses a scarcity of peer‐reviewed organizing frameworks of SDOH mechanisms designed to inform practice. The framework represents a practical tool to facilitate the translation of scholarly SDOH work into evidence‐based and targeted policy and programming. Such tools designed to close the research‐to‐practice translation gap for effective SDOH mitigation are sorely needed, given that health inequities in the United States and in many other parts of the world have widened over the past two decades.

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Mini-review: Elucidating the psychological, physical, and sex-based interactions between HIV infection and stress

Cited by 15 publications

References 167 publications

Reversibility of Central Nervous System Adverse Events in Course of Art

Reversibility of Central Nervous System Adverse Events in Course of Art

Translocation of bacterial LPS is associated with self-reported cognitive abilities in men living with HIV receiving antiretroviral therapy

Conceptualizing the Mechanisms of Social Determinants of Health: A Heuristic Framework to Inform Future Directions for Mitigation

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