Big Waistline in HIV Tied to Neurocognitive Impairment

Centrally-located obesity, but not body mass, linked to neurocognitive decline in HIV patients

MONDAY, Feb. 13 (HealthDay News) -- Central obesity is linked to an increased risk of decreased mental functioning in HIV-positive individuals, according to a study published in the Feb. 14 issue of Neurology.

J. Allen McCutchan, M.D., of the University of California in San Diego, and colleagues conducted a prospective, observational, multicenter cohort study to investigate the association between HIV-associated neurocognitive disorder and metabolic variables of 130 HIV+ individuals from a substudy of the central nervous system HIV Anti-Retroviral Therapy Effects Research (CHARTER) cohort, who provided fasting blood samples. Neurocognitive impairment (NCI) was defined as a global impairment rating ≥5, adjusting for age, education, gender, and race/ethnicity. Demographics, biomarkers of HIV disease, metabolic variables, combination antiretroviral therapy (CART) history, other drug exposures, and self-reported diabetes were examined in multivariate models. Separate models were used for body mass index (BMI) alone (90 participants) and BMI and waist circumference (WC) combined (55 participants).

The researchers found that age, longer duration of HIV infection, obesity, and WC, but not BMI, were associated with NCI in univariate analysis. Self-reported diabetes correlated with NCI in the substudy and in those aged >55 years in the entire CHARTER cohort. Central obesity, as measured by WC, increased the risk of NCI in multivariate analysis, and after accounting for the deleterious effect of central obesity, greater body mass was found to have possible protective effects.

"As in HIV-uninfected persons, central obesity, but not more generalized increases in body mass, was associated with a higher prevalence of NCI in HIV+ persons," the authors write.

Several authors disclosed financial ties to pharmaceutical companies.

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