Neurocognitive decline seen in heavy drinkers living with HIV
“In addition to an increased risk of physical illness (eg impairment than either condition alone.
Participants living with HIV (n = 86) and without HIV (n = 61) were stratified according to their HIV status and excessive alcohol consumption into 4 cohorts:
- HIV + / Binge + (n = 30)
- HIV− / Binge + (n = 23)
- HIV + / Binge− (n = 55)
- HIV− / Binge− (n = 38)
To be included, all participants had to report having consumed at least 1 glass of alcohol during the previous 30 days. Binge drinking was defined as consuming 4 or more drinks in 2 hours for women and 5 or more drinks in 2 hours for men. The analyzes were carried out in 3 ways:
- A complete neuropsychological battery for neurocognitive T scores
- Analysis of covariance models (ANCOVA) for independent / interactive influences of HIV and binge drinking on neurocognitive outcomes
- Multiple linear regressions to determine if HIV status / binge eating group influenced the relationship between age and neurocognition
Among the 4 groups evaluated, those who were double seropositive and who were considered heavy drinkers generally did the worst. Not only did they have poorer results on the 4 domains of neurocognitive ability previously mentioned compared to the other 3 groups (all P P > .05), wrote the authors.
However, when they reduced their analysis to a comparison between the HIV + / Binge + and HIV− / Binge− groups, “significant interactions between age and the HIV / Binge + group showed that HIV + / Binge + participants demonstrated stronger negative relationships between age and neurocognitive learning outcomes. , delayed recall and motor skills compared to HIV− / Binge− participants (all P <.05>
The majority of patients in the 4 groups were males and whites. People in the HIV + / Binge− group had the oldest mean (SD) age, at 46.42 (1.34), while those in the HIV− / Binge− group were the youngest, at 35.50 ( 11.95) years. The most common comorbidity was Lifetime Major Depressive Disorder, and all groups reported a history of Lifetime Alcohol Use Disorder (HIV− / Binge−, 13.2%; HIV- / Binge +, 82.6%; HIV + / Binge–, 27.3%; HIV + / Binge +, 83.3%; all P <.001>
The analyzes also revealed an important omnibus difference between the 4 groups of patients in the mean global neurocognitive function (F  = 4.39; P = .006), due to differences in the following:
- Processing speed (F  = 3.86; P = .011)
- Delayed recall (F  = 3.27; P = .023)
- Working memory (F  = 3.851; P = .011)
In addition, the cumulative negative effects of HIV and excessive alcohol consumption could be observed in the results of the Jonckheere-Terpstra tests which indicated a significantly smaller overall decrease (JT = 2303.5; P P = 0.001) performance by increased risk (0 risks = HIV− / Binge−; 1 risk = HIV− / Binge + or HIV + / Binge−; 2 risks = HIV + / Binge +), and recall and working memory deficits were more likely with binge drinking.
For the influence of age on these results, by multiple linear regression, the researchers found significantly worse results in the HIV + / Binge + group compared to the HIV- / Binge- group for the following:
- HIV + / Binge +: b = -0.43 (P = 0.001)
- HIV- / Binge-: b = -0.06 (P = .647)
- Delayed reminder:
- HIV + / Binge +: b = -0.47 (P
- HIV- / Binge-: b = -0.05 (P = .690)
- Motor skills:
- HIV + / Binge +: b = -0.63 (P
- HIV- / Binge-: b = 0.04 (P = .811)
“Given the rapidly growing population of older people with and without HIV as well as the increased rates of binge drinking among them, studying the combined effects of HIV and binge drinking throughout of life is timely and important, ”the authors wrote. “Our finding of differences between HIV / Binge groups in the neurocognitive domains of processing speed, delayed recall, and working memory is also consistent with the frontostriatal and frontolimbic neural damage that has been observed in adult studies. living with HIV and heavy drinking. “
They recommend setting up clinical screening for binge drinking behaviors in patients living with HIV, especially because alcohol use disorder (AUD) is not a common diagnosis despite the behavior. excessive alcohol consumption. Psychoeducation and psychosocial interventions could also help reduce binge drinking in elderly patients.
Future studies should also investigate the results after reducing or stopping binge drinking behaviors in people living with HIV “given the evidence that improvements in neurocognitive functioning may be possible after prolonged sobriety after treatment. recovery of AUD among seropositive populations ”.
Paolillo EW, Saloner R, Kohli M, et al. Heavy alcohol use is linked to poor neurocognitive functioning in adults aging with HIV. J Int Neuropsychol Soc. Published online July 26, 2021. doi: 10.1017 / S1355617721000783