Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2013:5:11-22.
doi: 10.2147/NBHIV.S39573. Epub 2013 Jun 19.

Apolipoprotein-E genotype and human immunodeficiency virus-associated neurocognitive disorder: the modulating effects of older age and disease severity

Stella E Panos  1 , Charles H Hinkin  1 , Elyse J Singer  2 , April D Thames  1 , Sapna M Patel  1 , Janet S Sinsheimer  3 , A C Del Re  4 , Benjamin B Gelman  5 , Susan Morgello  6 , David J Moore  7 , Andrew J Levine  2
Affiliations

Apolipoprotein-E genotype and human immunodeficiency virus-associated neurocognitive disorder: the modulating effects of older age and disease severity

Stella E Panos et al. Neurobehav HIV Med. 2013.

Abstract

Background: The apolipoprotein-E (APOE) ε4 allele is a risk factor for vascular dementia and Alzheimer's disease. Recent studies are equivocal with regards to whether or not the ε4 allele confers increased risk for the development of human immunodeficiency virus (HIV)-associated neurocognitive disorder (HAND), but suggest that age and/or disease severity may be modulating factors. The aim of this study was to assess the interactions and contributions of APOE genotype, age, and HIV disease severity as risk factors for HAND in HIV-infected adults.

Methods: Participants were 259 HIV-positive individuals who underwent APOE genotyping, a standardized neurological evaluation, a comprehensive neuropsychological evaluation, and laboratory testing.

Results: Older ε4 carriers showed a higher frequency of HAND compared with age-matched non-ε4 carriers. Analysis by discrete neurocognitive domain revealed that advanced age modulated the effect of the ε4 allele, such that older ε4 allele carriers showed reduced executive functioning and information processing speed. Exploratory analyses assessing the relationship between ε4 and disease severity in the overall sample revealed that disease severity modulated the effect of the ε4 allele on cognition. Lower absolute CD4+ cell count among ε4 allele carriers was associated with poorer working memory ability.

Conclusion: Advancing age and degree of immunosuppression may influence the association between APOE ε4 allele status and HAND. These two factors need to be taken into account in future research.

Keywords: aging; apolipoprotein-E; human immunodeficiency virus; neurocognition.

PubMed Disclaimer

Conflict of interest statement

Disclosure

The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Percentage of apolipoprotein-E allele combinations by age group.
Figure 2
Figure 2
Interaction between apolipoprotein-E genotype on executive functions.
Figure 3
Figure 3
Interaction between apolipoprotein-E genotype and disease severity on working memory.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Detels R, Munoz A, McFarlane G, et al. Effectiveness of potent anti-retroviral therapy on time to AIDS and death in men with known HIV infection duration. Multicenter AIDS Cohort Study Investigators. JAMA. 1998;280(17):1497–1503. - PubMed
    1. Centers for Disease Control. HIV/AIDS Surveillance Report, 2005. Atlanta, GA: US Department of Health and Human Services; 2007. [Accessed January 13, 2013]. Available from: http://www.cdc.gov/hiv/topics/surveillance/resources/reports/2005report/....
    1. Dilley JW, Schwarcz S, Loeb L, Hsu L, Nelson K, Scheer S. The decline of incident cases of HIV-associated neurological disorders in San Francisco, 1991–2003. AIDS. 2005;19(6):634–635. - PubMed
    1. Heaton RK, Clifford DB, Franklin DR, Jr, et al. HIV-associated neurocognitive disorders persist in the era of potent antiretroviral therapy: CHARTER study. Neurology. 2010;75(23):2087–2096. - PMC - PubMed
    1. Sacktor N. The epidemiology of human immunodeficiency virus-associated neurological disease in the era of highly active antiretroviral therapy. J Neurovirol. 2002;(8 Suppl 2):115–121. - PubMed

LinkOut - more resources