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Longitudinal Change in Cognitive Function and Medication Adherence in HIV-Infected Adults

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Abstract

Neuropsychological (NP) dysfunction has been linked to poor medication adherence among HIV-infected adults. However, there is a dearth of research examining longitudinal changes in the relationship between NP status and adherence rates. We hypothesized that declines in NP functioning would be associated with a corresponding decline in medication adherence while stable NP functioning would be associated with stable or improving adherence rates. Participants included 215 HIV-infected adults who underwent cognitive testing at study entry and six months later. Compared to the NP stable group, the NP decline group showed a greater drop in adherence rates. Further analysis revealed that, beyond global NP, learning and memory was significantly associated with changes in adherence rates. These findings further support the link between cognitive functioning and medication adherence and illustrates the importance of documenting changes in cognitive abilities for identifying individuals at risk for poor adherence.

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References

  1. Karon JM, Dondero TJ, Curran JW. The projected incidence of AIDS and estimated prevalence of HIV infection in the United States. J Acquir Immune Defic Syndr. 1988;1(6):542–50.

    PubMed  CAS  Google Scholar 

  2. Murphy DA, Wilson CM, Durako SJ, Muenz LR, Belzer M. Adolescent medicine HIV/AIDS research network. Antiretroviral medication adherence among the reach HIV-infected adolescent cohort in the USA. AIDS Care. 2001;13:27–40.

    Article  PubMed  CAS  Google Scholar 

  3. Casado JL, Sabido R, Perez-Elías MJ, et al. Percentage of adherence correlates with the risk of protease inhibitor (PI) treatment failure in HIV-infected patients. Antivir Ther. 1999;4(3):157–61.

    PubMed  CAS  Google Scholar 

  4. Maggiolo F, Airoldi M, Kleinloog HD, et al. Effect of adherence to HAART on virologic outcome and on the selection of resistance-conferring mutations in NNRTI- or PI-treated patients. HIV Clin Trials. 2007;8:282–92.

    Article  PubMed  Google Scholar 

  5. Howard AA, Arnsten JH, Lo Y, et al. A prospective study of adherence and viral load in a large multi-center cohort of HIV-infected women. AIDS. 2002;16:2175–82.

    Article  PubMed  CAS  Google Scholar 

  6. Bangsberg DR, Hecht FM, Charlesbois ED, et al. Adherence to protease inhibitors, HIV-1 viral load, and development off drug resistance in an indigent population. AIDS. 2000;14:357–66.

    Article  PubMed  CAS  Google Scholar 

  7. Paterson DL, Swindells S, Mohr J, et al. Adherence to protease inhibitor therapy and outcomes in patients with HIV infection. Ann Intern Med. 2000;133:21–30.

    PubMed  CAS  Google Scholar 

  8. Murphy EL, Collier AC, Kalish KA, et al. Highly active antiretroviral therapy decreases mortality and morbidity in patients with advanced HIV disease. Ann Intern Med. 2001;135:17–26.

    PubMed  CAS  Google Scholar 

  9. Nieuwkerk PT, Gisolf EH, Reijers MHE, Lange JMA, Danner SA, Sprangers MAG. Long-term quality of life outcomes in three antiretroviral treatment strategies for HIV-1 infection. AIDS. 2001;15:1985–91.

    Article  PubMed  CAS  Google Scholar 

  10. Hinkin CH, Barclay TR, Castellon SA, et al. Drug use and medication adherence among HIV-1 infected individuals. AIDS Behav. 2007;11:185–94.

    Article  PubMed  Google Scholar 

  11. Perno CF, Ceccherini-Silberstein F, De Luca A, et al. Virologic correlates of adherence to antiretroviral medications and therapeutic failure. J Acquir Immune Defic Syndr. 2002;31(3):S118–22.

    PubMed  Google Scholar 

  12. Harrigan PR, Hogg RS, Dong WW, et al. Predictors of HIV drug-resistance mutations in a large antiretroviral-naive cohort initiating triple antiretroviral therapy. J Infect Dis. 2005;191:339–47.

    Article  PubMed  CAS  Google Scholar 

  13. Lima VD, Geller J, Bangsberg DR, et al. The effect of adherence on the association between depressive symptoms and mortality among HIV-infected individuals first initiating HAART. AIDS. 2007;21(9):1175–83.

    Article  PubMed  Google Scholar 

  14. Bornstein RA, Nasrallah HA, Para MF, Whitacre CC, Rosenberger P, Fass RJ. Neuropsychological performance in symptomatic and asymptomatic HIV infection. AIDS. 1993;7:519–24.

    Article  PubMed  CAS  Google Scholar 

  15. Heaton RK, Grant I, Butters N, et al. The HNRC 500—neuropsychology of HIV infection at different disease stages. HIV neurobehavioral research center. J Int Neuropsychol Soc. 1995;1(3):231–51.

    Article  PubMed  CAS  Google Scholar 

  16. Hinkin CH, van Gorp WG, Satz P. Neuropsychological aspects of HIV infection. In: Kaplan HI, Saddock BJ, editors. The comprehensive textbook of psychiatry, vol. VI. Oxford: Blackwell; 1995.

    Google Scholar 

  17. Miller EN, Seines OA, McArthur JC, et al. Neuropsychological performance in HIV-1-infected homosexual men: the multicenter aids cohort study (MACS). Neurology. 1990;40:197–203.

    PubMed  CAS  Google Scholar 

  18. Barclay TR, Hinkin CH, Castellon SA, et al. Age-associated predictors of medication adherence in HIV-positive adults: health beliefs, self-efficacy, and neurocognitive status. Health Psychol. 2007;26:40–9.

    Article  PubMed  Google Scholar 

  19. Hinkin CH, Castellon SA, Durvasula RS, et al. Medication adherence among HIV + adults: effects of cognitive dysfunction and regimen complexity. Neurology. 2002;59:1944–50.

    PubMed  CAS  Google Scholar 

  20. Hinkin CH, Hardy DJ, Mason KI, et al. Medication adherence in HIV-infected adults: effect of patient age, cognitive status, and substance abuse. AIDS. 2004;18:19–25.

    Article  Google Scholar 

  21. Levine A, Hinkin C, Castellon S, Mason K, Lam M, Perkins A. Variations in patterns of highly active antiretroviral therapy (HAART) adherence. AIDS Behav. 2005;9:355–62.

    Article  PubMed  Google Scholar 

  22. Heaton RK, Grant I, Matthews CG. Comprehensive norms for an expanded Halstead–Reitan battery: demographic corrections, research findings, and clinical applications. Odessa: Psychological Assessment Resources; 1991.

    Google Scholar 

  23. Spitzer RL, Williams JB, Gibbon M, First MB. The structured clinical interview for DSM-II-R (SCID). I: History, rationale, and description. Arch. Gen Psychiatry. 1992;49(8):624–9.

    CAS  Google Scholar 

  24. Carey CL, Woods SP, Gonzalez R, et al. Predictive validity of global deficit scores in detecting neuropsychological impairment in HIV infection. J Clin Exp Neuropsychol. 2004;26:307–19.

    Article  PubMed  Google Scholar 

  25. Lovejoy TI, Suhr JA. The relationship between neuropsychological functioning and HAART adherence in HIV-positive adults: a systematic review. J Behav Med. 2009;32(5):389–405.

    Article  PubMed  Google Scholar 

  26. Contardo C, Black AC, Beauvais J, Dieckhaus K, Rosen MI. Relationship of prospective memory to neuropsychological function and antiretroviral adherence. Arch Clin Neuropsychol. 2009;24:547–54.

    Article  PubMed  Google Scholar 

  27. Woods SP, Iudicello JE, Moran LM, et al. HIV-associated prospective memory impairment increases risk of dependence in everyday functioning. Neuropsychology. 2008;22:110–7.

    Article  PubMed  Google Scholar 

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Acknowledgments

This study was supported by a grant from the National Institute on Drug Abuse (RO1 DA13799) and by National Institute of Mental health Grant T32 MH19535 awarded to CHH. Support for Brian Becker was provided by the Department of Veterans Affairs Geriatric Research Education and Clinical Center. We would also like to acknowledge the help of our RAs: Michelle Kim, Gabe Waterman, Sara-Beth Lawrence, Melissa Choi, Jiah Jang, Laurie Chew, Arielle Newman, and Sloane Miller.

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Authors and Affiliations

  1. Neuropsychology Lab (256), VA Greater Los Angeles Health Care System, 11301 Wilshire, Boulevard, Los Angeles, CA, 90073, USA

    Brian W. Becker, Steven A. Castellon & Charles H. Hinkin

  2. David Geffen School of Medicine at UCLA, Los Angeles, CA, USA

    Brian W. Becker, April D. Thames, Ellen Woo, Steven A. Castellon & Charles H. Hinkin

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  1. Brian W. Becker
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  2. April D. Thames
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  3. Ellen Woo
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  4. Steven A. Castellon
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  5. Charles H. Hinkin
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Correspondence to Brian W. Becker.

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Becker, B.W., Thames, A.D., Woo, E. et al. Longitudinal Change in Cognitive Function and Medication Adherence in HIV-Infected Adults. AIDS Behav 15, 1888–1894 (2011). https://doi.org/10.1007/s10461-011-9924-z

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