Cognitive complications persist in antiretroviral therapy(ART)-treated people with HIV. However, the pattern and severity of domain-specific cognitive performance is variable and may be exacerbated by ART-mediated neurotoxicity. 929 women with HIV(WWH) from the Women’s Interagency HIV Study who were classified into subgroups based on sociodemographic and longitudinal behavioral and clinical data using semi-parametric latent class trajectory modelling. Five subgroups were comprised of: 1) well-controlled HIV with vascular comorbidities(n = 116); 2) profound HIV legacy effects(CD4 nadir <250 cells/μL; n = 275); 3) primarily <45 year olds with hepatitis C(n = 165); 4) primarily 35–55 year olds(n = 244), and 5) poorly-controlled HIV/substance use(n = 129). Within each subgroup, we fitted a constrained continuation ratio model via penalized maximum likelihood to examine adjusted associations between recent ART agents and cognition. Most drugs were not associated with cognition. However, among the few drugs, non-nucleoside reverse transcriptase inhibitor (NNRTIs) and protease inhibitors(PIs) were most commonly associated with cognition, followed by nucleoside reverse transcriptase inhibitors(NRTIs) and integrase inhibitors(IIs). Directionality of ART-cognition associations varied by subgroup. Better psychomotor speed and fluency were associated with ART for women with well-controlled HIV with vascular comorbidities. This pattern contrasts women with profound HIV legacy effects for whom poorer executive function and fluency were associated with ART. Motor function was associated with ART for younger WWH and primarily 35–55 year olds. Memory was associated with ART only for women with poorly-controlled HIV/substance abuse. Findings demonstrate interindividual variability in ART-cognition associations among WWH and highlight the importance of considering sociodemographic, clinical, and behavioral factors as an underlying contributors to cognition.

Are antiretroviral agents a risk factor for cognitive complications in women with HIV? We examind associations between ART-agents and cognitive function among similar subgroups of women with HIV from the Women's Interagency HIV study. The patterns of associations depended on sociodemographic, clinical, and behavioral characteristics of women.

接受抗逆转录病毒疗法（ART）治疗的艾滋病毒感染者持续存在认知并发症。然而，特定领域认知表现的模式和严重程度是可变的，并且可能因 ART 介导的神经毒性而加剧。来自妇女机构间艾滋病毒研究的 929 名艾滋病毒感染者 (WWH) 女性，使用半参数潜在类别轨迹模型，根据社会人口统计学、纵向行为和临床数据将她们分为亚组。五个亚组包括：1）控制良好的 HIV 并伴有血管合并症（n  = 116）；2) 深刻的 HIV 遗留影响（CD4 最低值 <250 个细胞/μL；n  = 275）；3）主要是<45岁的丙型肝炎患者（n  = 165）；4) 主要是 35-55 岁的人 ( n  = 244)，以及 5) 艾滋病毒/药物使用控制不力 ( n  = 129)。在每个亚组中，我们通过惩罚最大似然拟合了一个约束连续比模型，以检查最近 ART 药物与认知之间的调整关联。大多数药物与认知无关。然而，在少数药物中，非核苷逆转录酶抑制剂（NNRTI）和蛋白酶抑制剂（PI）最常与认知相关，其次是核苷逆转录酶抑制剂（NRTI）和整合酶抑制剂（II）。ART 认知关联的方向性因亚组而异。对于艾滋病毒控制良好且患有血管合并症的女性来说，更好的精神运动速度和流畅性与 ART 相关。这种模式与具有严重艾滋病毒遗留影响的女性形成鲜明对比，对她们来说，较差的执行功能和流畅性与 ART 相关。对于年轻的 WWH，主要是 35-55 岁的人，运动功能与 ART 相关。仅对于艾滋病毒/药物滥用控制不佳的女性，记忆力与抗逆转录病毒治疗有关。研究结果表明，WWH 中 ART 认知关联存在个体差异，并强调了将社会人口统计学、临床和行为因素视为认知潜在影响因素的重要性。

抗逆转录病毒药物是艾滋病毒女性认知并发症的危险因素吗？我们在妇女机构间艾滋病毒研究中检查了艾滋病毒感染女性类似亚群中抗逆转录病毒治疗药物与认知功能之间的关联。关联模式取决于女性的社会人口、临床和行为特征。