Psychiatric and substance use disorders comorbidities in veterans with hepatitis C virus and HIV coinfection

Fuller, Bret E.; Loftis, Jennifer M.; Rodriguez, Veronica L.; McQuesten, Matthew J; Hauser, Péter

doi:10.1097/yco.0b013e32832cadb9

Cited by 17 publications

(14 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Further, individuals who are infected with one virus have an increased risk of coinfection with the other. Given the high rates of comorbid viral infection with substance use disorders (Fuller, Loftis, Rodriguez, McQuesten, & Hauser, 2009; Loftis, Matthews, & Hauser, 2006), particularly psychostimulant dependence (e.g., Buchacz et al, 2005), the combined effects of substance use disorders and HIV and/or HCV on neural-immune interactions are of scientific and clinical interest (Cadet & Krasnova, 2007). In addition, the effects of chronic viral infection on brain are likely exacerbated by the adverse effects of comorbid methamphetamine dependence on BBB integrity and function (Liang et al, 2008) (Fig.…”

Section: Partmentioning

confidence: 99%

Neuroimmune Basis of Methamphetamine Toxicity

Loftis

Janowsky

2014

International Review of Neurobiology

105

View full text Add to dashboard Cite

Although it is not known which antigen-specific immune responses (or if antigen-specific immune responses) are relevant or required for methamphetamine's neurotoxic effects, it is apparent that methamphetamine exposure is associated with significant effects on adaptive and innate immunity. Alterations in lymphocyte activity and number, changes in cytokine signaling, impairments in phagocytic functions, and glial activation and gliosis have all been reported. These drug-induced changes in immune response, particularly within the CNS, are now thought to play a critical role in the addiction process for methamphetamine dependence as well as for other substance use disorders. In Section 2, methamphetamine's effects on glial cell (e.g., microglia and astrocytes) activity and inflammatory signaling cascades are summarized, including how alterations in immune cell function can induce the neurotoxic and addictive effects of methamphetamine. Section 2 also describes neurotransmitter involvement in the modulation of methamphetamine's inflammatory effects. Section 3 discusses the very recent use of pharmacological and genetic animal models which have helped elucidate the behavioral effects of methamphetamine's neurotoxic effects and the role of the immune system. Section 4 is focused on the effects of methamphetamine on blood–brain barrier integrity and associated immune consequences. Clinical considerations such as the combined effects of methamphetamine and HIV and/or HCV on brain structure and function are included in Section 4. Finally, in Section 5, immune-based treatment strategies are reviewed, with a focus on vaccine development, neuroimmune therapies, and other anti-inflammatory approaches.

show abstract

Section: Partmentioning

confidence: 99%

Neuroimmune Basis of Methamphetamine Toxicity

Loftis

Janowsky

2014

International Review of Neurobiology

105

View full text Add to dashboard Cite

show abstract

“…Nevertheless, we believe that these comorbidities are representative of HIV and alcoholism patient samples, as has been reported previously (e.g., Bräu et al, 2002; Rosenbloom et al, 2007). For example, Fuller, Loftis, Rodriguez, McQuesten, and Hauser (2009) reported in his review article that 15 to 37% of HIV-1 infected people also have HCV.…”

Section: Differential Diagnostic Effects On Cognitive Control and Emomentioning

confidence: 99%

Disruption of Emotion and Conflict Processing in HIV Infection with and without Alcoholism Comorbidity

Schulte

Müller‐Oehring

Sullivan

et al. 2011

J Int Neuropsychol Soc

View full text Add to dashboard Cite

Alcoholism and HIV-1 infection each affect components of selective attention and cognitive control that may contribute to deficits in emotion processing based on closely interacting fronto-parietal attention and frontal-subcortical emotion systems. Here, we investigated whether patients with alcoholism, HIV-1 infection, or both diseases have greater difficulty than healthy controls in resolving conflict from emotional words with different valences. Accordingly, patients with alcoholism (ALC, n = 20), HIV-1 infection (HIV, n = 20), ALC + HIV comorbidity (n = 22), and controls (CTL, n = 16) performed an emotional Stroop Match-to-Sample task, which assessed the contribution of emotion (happy, angry) to cognitive control (Stroop conflict processing). ALC + HIV showed greater Stroop effects than HIV, ALC, or CTL for negative (ANGRY) but not for positive (HAPPY) words, and also when the cue color did not match the Stroop stimulus color; the comorbid group performed similarly to the others when cue and word colors matched. Furthermore, emotionally salient face cues prolonged color-matching responses in all groups. HIV alone, compared with the other three groups, showed disproportionately slowed color-matching time when trials featured angry faces. The enhanced Stroop effects prominent in ALC + HIV suggest difficulty in exercising attentional top-down control on processes that consume attentional capacity, especially when cognitive effort is required to ignore negative emotions.

show abstract

“…However, inner-city and veteran populations with serious co-morbidities can present special challenges to achieving these gains. These comorbidities [3]–[6] which often include alcohol and substance abuse [7]–[9] and mental illness [10]–[12] can lead to concurrent disease manifestations and drug-drug interactions. Compared to those without infection, HIV-infected patients also have higher rates of poor treatment adherence due to lack of family/social support, adverse drug effects, complex drug regimens, psychological distress, and low patient self-efficacy [13],[14].…”

Section: Introductionmentioning

confidence: 99%

Progress Realized: Trends in HIV-1 Viral Load and CD4 Cell Count in a Tertiary-Care Center from 1999 through 2011

et al. 2013

View full text Add to dashboard Cite

BackgroundHIV-1 RNA and CD4 cell counts are important parameters for HIV care. The objective of this study was to assess the overall trends in HIV-1 viral load and CD4 cell counts within our clinic.MethodsPatients with at least one of each test performed by the Infectious Diseases Laboratory from 1999 through 2011 were included in this analysis. By adapting a novel statistical model, log10 HIV-1 RNA means were estimated by month, and log10-transformed HIV-1 RNA means were estimated by calendar year. Geometric means were calculated for CD4 cell counts by month and calendar year. Log10 HIV-1 RNA and CD4 cell count monthly means were also examined with polynomial regression.ResultsThere were 1,814 individuals with approximately 25,000 paired tests over the 13-year observation period. Based on each patient's final value of the year, the percentage of patients with viral loads below the lower limit of quantitation rose from 29% in 1999 to 72% in 2011, while the percentage with CD4 counts <200 cells/µL fell from 31% to 11%. On average annually, the mean HIV-1 RNA decreased by 86 copies/mL and the mean CD4 counts increased by 16 cells/µL. For the monthly means, the correlations (R2) from second-order polynomial regressions were 0.944 for log10 HIV-1 RNA and 0.840 for CD4 cell counts.ConclusionsMarked improvements in HIV-1 RNA suppression and CD4 cell counts were achieved in a large inner-city population from 1999 through 2011. This success demonstrates that sustained viral control with improved immunologic status can be a realistic goal for most individuals in clinical care.

show abstract

Psychiatric and substance use disorders comorbidities in veterans with hepatitis C virus and HIV coinfection

Abstract: With this understanding of the comorbidities of the coinfected population, integrated healthcare models involving mental health, internal medicine, substance abuse treatment and internal medicine are crucial to work with these medically and psychologically complex patients.

Cited by 17 publications

References 37 publications

Neuroimmune Basis of Methamphetamine Toxicity

Neuroimmune Basis of Methamphetamine Toxicity

Disruption of Emotion and Conflict Processing in HIV Infection with and without Alcoholism Comorbidity

Progress Realized: Trends in HIV-1 Viral Load and CD4 Cell Count in a Tertiary-Care Center from 1999 through 2011

Contact Info

Product

Resources

About