Cognitive function among antiretroviral treatment-naïve individuals infected with HIV-1 Subtype G versus CRF02_AG in Nigeria

Abstract

Background

HIV-1 subtype has been shown to be associated with disease progression. We compared cognitive function between individuals infected with HIV-1 subtype G and CRF02_AG in Nigeria.

Methods

For this cross-sectional study, samples were analyzed from 146 antiretroviral naïve participants. Genotypic analysis of plasma HIV RNA was performed by nested PCR of protease and reverse transcriptase genes, and sequences aligned with curated HIV-1 subtype references. Cognitive status was determined using demographically adjusted T scores and global deficit scores (GDS) obtained from a comprehensive neuropsychological test battery.

Results

A total of 76 (52.1%) participants were infected with CRF02_AG, 48 (32.8%) with subtype G, and 22 (15.1%) with other HIV-1 strains. In a multivariable linear regression adjusting for plasma HIV RNA, CD4 count and depression score, mean global T score was lower among subtype G as compared to CRF02_AG infected participants (Mean difference: -3.0 [95% CI: -5.2,-0.7]; P = .011). Also, T scores were significantly lower among subtype G than CRF02_AG infected participants for the speed of information processing, executive function, and verbal fluency ability domains. Adjusting for similar variables in a logistic regression, the odds of global cognitive impairment (GDS ≥ 0.5) were 2.2 times higher among subtype G as compared to CRF02_AG infected participants (OR: 2.2 [95% CI: 0.9, 5.4]; P = .078).

Conclusion

Cognitive performance was significantly worse among antiretroviral naïve individuals with HIV-1 subtype G versus CRF02_AG infection. Further studies are required to characterize the mechanistic basis for these differences.