Stress hormone biomarkers and cognitive functions among HIV-positive patients with opioid use disorder

Abstract

Aim -to investigate the role of the detoxification-associated stress on cognitive functions during early remission among HIV-positive patients with opioid use disorder.Material and methods. Prospective cohort study among HIV-positive patients with opioid use disorder (n=41) who admitted at the hospital for detoxification due to opioid withdrawal syndrome. Participants were assessed at four visits: Visit 0 -at hospital admission (Day 0); Visit 1 -the peak of withdrawal (Days 3-5); Visit 2 -at the end of detoxification therapy (Day 10-14) and Visit 3 -early remission (Days 21-40). We applied experimental psychological and clinical psychopathological methods, also laboratory assessment of plasma cortisol, dehydroepiandrosterone (DHEA) and dehydroepiandrosterone-sulfate (DHEA-S) levels was conducted.Results. The level of cortisol in plasma was elevated while DHEA-S level was decreased during whole period of observation. The intensity of cognitive impairment were gradually decreased over 3 weeks after detoxification compared to withdrawal treatment period (p<0.05). In regression model we found that increased ratio of cortisol to DHEA during withdrawal was associated with severe cognitive deficits during remission [regression coefficient (95% CI) = -1.2 (-2; -0.4)]. Conclusion.Our funding shown that cognitive impairment, including decreased information proceeding speed, learning and memory in HIV-positive patients remain during several weeks after opioid detoxification treatment. The study results suggested the hypothalamic pituitary adrenal system dysfunction which activated by the cessation of opioid use and withdrawal. We conclude that the neuroendocrine system was involved in the development of cognitive impairment in HIV-positive patients during opioid withdrawal syndrome.