No association between Apoε4 alleles, HIV infection, age, neuropsychological outcome, or death

Abstract

The ε4 allele of the ApoE gene may have important interactions with physical health and cognitive function among individuals with HIV disease. The purpose of this study is to examine the relationships between ε4, HIV disease, age, neuropsychological impairment and death in a large, well-characterized study sample. 2,846 men participating in the Multicenter AIDS Cohort Study had ApoE genotyping and neuropsychological test data available for analysis. We found a significant association between HIV infection and time to death (from any cause), as well as older age, race, and education. But, ApoE status was not significantly associated with time to death. Similarly, we found a significant association between HIV infection and time to incident cognitive impairment, as well as age, education, and HIV serostatus; Apoε4 status was not related to incident cognitive impairment. There were no significant interactions between ApoE, HIV infection, and age on cognitive impairment. These data replicate and strengthen prior findings of the lack of association between ApoE ε4 and cognitive outcomes in HIV disease. We conclude that within the specific constraints of an exclusively male study in which the majority of participants were less than 65 years of age (range: 22-87 years), it appears reasonable to conclude that the ε4 allele is not significantly interacting with HIV serostatus.

ApoE ε4 Is Associated With Cognition, Brain Integrity, and Atrophy in HIV Over Age 60

“…19,20 Similarly, investigations from the Multicenter AIDS Cohort Study (MACS, with mean ages at enrollment across groups between 30 to 40 years) do not identify an impact of ApoE ε4 on development of cognitive impairment among participants who tested normal at baseline. 21 One group carefully tested the hypothesis that age may influence the association between ApoE ε4 carrier status and cognitive outcomes using data from the National NeuroAIDS Tissue Consortium (NNTC) noting detrimental effects on HAND diagnosis, executive functioning and information processing in older age (> 50 years) but not in those of younger age. 14 …”

Novel Neuroimaging Methods to Understand How HIV Affects the Brain

“…Regardless of the utility of brain MRI for routine clinical evaluations, there are many large multi-site neuroimaging studies such as COBRA (http://fp7-cobra.eu/) in the European Union, and - in the United States - CHARTER [7, 8], the Multi-Cohort AIDS Study [9] (MACS) and the HIV Neuroimaging Consortium, or HIVNC [10]. Global neuroimaging consortia, such as Enhancing Neuro Imaging Genetics Through Meta Analysis (ENIGMA, http://enigma.ini.usc.edu/) [11], are pooling brain scan and clinical data from over 30 countries.…”

Lipid Profiles and APOE4 Allele Impact Midlife Cognitive Decline in HIV-Infected Men on Antiretroviral Therapy

“…The ϵ4 allele is the most important genetic risk factor for Alzheimer's disease, and is a risk factor for age-related cognitive decline in the general population [ 8 ]. The relationship between APOE genotype and HAND is unclear due to conflicting results [ 9 – 22 ]. While some cross-sectional studies suggest that the ϵ4 allele increases risk for HAND over age 50 [ 12 , 19 ], others found no significant cognitive effect of the ϵ4 allele in HIV + adults [ 9 , 11 , 13 , 20 , 22 ].…”