ART reduces Alzheimer’s prevalence among patients with HIV
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The prevalence of Alzheimer’s disease is elevated among patients with HIV, and the prevalence of early onset Alzheimer’s disease is even higher among patients who are not being treated with ART, study findings showed.
Researchers also found that ART reduces the prevalence of Alzheimer’s disease among patients with HIV to the same seen among patients without HIV, according to data presented at the Annual Meeting of the American Neurological Association.
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“The survivors of the early waves [of the HIV epidemic in the United States] are entering seniorhood,” Guodong Liu, PhD, associate professor of public health sciences and neurology, pediatrics, psychiatry and behavioral health at the Penn State University College of Medicine, told Healio.
“While we’ve already known HIV is associated with certain types of dementia different from Alzheimer’s disease it has been rumored, even hypothesized by some investigators, that HIV may increase the risk of AD. However, no solid evidence has yet been found.”
Liu and colleagues used the MarketScan national health care claims database of privately insured individuals in the U.S. to assess the risk for early onset AD among patients with HIV aged 64 years or younger.
They identified 74,144 patients with HIV enrolled in the database for at least 1 year during the study period who were aged at least 50 years during any point of the study period. According to the study, 44.3% did not receive ART during the study period, and there was an elevated prevalence of AD among patients with HIV (0.11%) compared with those without HIV (0.07%). The study demonstrated that the prevalence of early-onset AD was even higher among those without ART treatment (0.16%).
Additionally, it showed that the prevalence of AD among patients treated with ART was the same as individuals without HIV (0.07%).
According to the researchers, an analysis confirmed that HIV infection was associated with a higher risk for early-onset AD (adjusted OR = 1.56; 95% CI, 1.24-1.97), whereas ART treatment was associated with lower AD risk (aOR = 0.50; CI, 0.30-0.81) after adjusting for heart disease, hypertension, diabetes, age and gender among other demographic variables.
In terms of how and why ART lowers the risk for AD, Liu said they speculate that ART may reduce the neurological toxicity due to unsuppressed HIV virus, or that ART may reduce the prevalence of other medical conditions that were highly prevalent among patients with HIV, including hypertension, diabetes and high cholesterol, which are risk factors for AD.
“It is critical for HIV patients to stay on or adhere to ART so to minimize the risk of AD due to HIV,” Liu said.
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Liu G, et al. Abstract 537. Presented at: Annual Meeting of the American Neurological Association. Oct. 4-9, 2020; virtual.
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