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Chronically elevated depressive symptoms interact with acute increases in inflammation to predict worse neurocognition among people with HIV

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Abstract

We examined the joint effects of depressive symptoms (Beck Depression Inventory-II (BDI-II)) and systemic inflammation (plasma C-reactive protein (CRP)) on longitudinal profiles of neurocognition in a cohort of 143 people with HIV (PWH) on antiretroviral therapy. Global neurocognition, processing speed, motor skills, and attention/working memory all worsened as CRP increased but only among PWH who, on average, exhibited moderate to severe depressive symptoms (BDI-II > 22). Findings suggest that some PWH with chronically elevated depressive symptoms may have an inflammatory subtype of depression and a particular vulnerability to neurocognitive changes that may respond to drugs targeting inflammation or its neural sequelae.

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Acknowledgements

The San Diego HIV Neurobehavioral Research Center [HNRC] group is affiliated with the University of California, San Diego; the Naval Hospital, San Diego; and the Veterans Affairs San Diego Healthcare System, and includes Director: Robert K. Heaton, Ph.D., and Co-Director: Igor Grant, M.D.; Associate Directors: J. Hampton Atkinson, M.D.; Ronald J. Ellis, M.D., Ph.D.; and Scott Letendre, M.D.; Center Manager: Jennifer Iudicello, Ph.D.; Donald Franklin, Jr.; and Melanie Sherman; NeuroAssessment Core: Ronald J. Ellis, M.D., Ph.D. (P.I.); Scott Letendre, M.D.; Thomas D. Marcotte, Ph.D.; Christine Fennema-Notestine, Ph.D.; Debra Rosario, M.P.H.; and Matthew Dawson; NeuroBiology Core: Cristian Achim, M.D., Ph.D. (P.I.); Ana Sanchez, Ph.D.; and Adam Fields, Ph.D.; NeuroGerm Core: Sara Gianella Weibel, M.D. (P.I.); David M. Smith, M.D.; Rob Knight, Ph.D., and Scott Peterson, Ph.D.; Developmental Core: Scott Letendre, M.D. (P.I.) and J. Allen McCutchan; Participant Accrual and Retention Unit: J. Hampton Atkinson, M.D. (P.I.); Susan Little, M.D.; and Jennifer Marquie-Beck, M.P.H.; Data Management and Information Systems Unit: Lucila Ohno-Machado, Ph.D. (P.I.) and Clint Cushman; Statistics Unit: Ian Abramson, Ph.D. (P.I.); Florin Vaida, Ph.D. (Co-PI),; and Anya Umlauf, M.S., Bin Tang, M.S.

Funding

Data for this study were collected as part of two larger studies: (1) the HIV Neurobehavioral Research Center (HNRC; NIMH award P30MH062512) and (2) the CNS HIV Anti-Retroviral Therapy Effects Research program (CHARTER; NIH HHSN271201000036C and HHSN271201000030C). Additional funding was supported by NIA award F31AG064989 (stipend support to R.S.) and NIAAA award F31AA027198 (stipend support to E.W.P.).

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Authors and Affiliations

  1. San Diego Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego, CA, USA

    Rowan Saloner & Emily W. Paolillo

  2. Department of Psychiatry, University of California, La Jolla, San Diego, CA, USA

    Rowan Saloner, Emily W. Paolillo, Robert K. Heaton, David J. Grelotti, Murray B. Stein, J. Hampton Atkinson, Scott L. Letendre, Ronald J. Ellis, Igor Grant, Jennifer E. Iudicello & David J. Moore

  3. Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA

    Andrew H. Miller

  4. Department of Medicine, University of California, La Jolla, San Diego, CA, USA

    Scott L. Letendre

  5. Department of Neurosciences, University of California, La Jolla, San Diego, CA, USA

    Ronald J. Ellis

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  1. Rowan Saloner
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Correspondence to David J. Moore.

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Saloner, R., Paolillo, E.W., Heaton, R.K. et al. Chronically elevated depressive symptoms interact with acute increases in inflammation to predict worse neurocognition among people with HIV. J. Neurovirol. 27, 160–167 (2021). https://doi.org/10.1007/s13365-020-00925-1

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