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Sex differences in neurocognitive screening among adults living with HIV in China

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Abstract

HIV-infected (HIV+) women may be more vulnerable to neurocognitive impairment (NCI) due to psychological and physiological factors but previous studies show mixed findings. We investigated the neurocognitive performances in HIV+ versus HIV− women and men. This cross-sectional analysis included 669 HIV+ patients (223 women) and 1338 HIV-uninfected (HIV−) controls (446 women) which were frequency matched on sex, education, and 5-year age categories. NCI was screened using the Mini-mental State Examination. Psychomotor speed was assessed using timed alternating hand sequence test. Prevalence of NCI was higher among women versus men in the HIV+ group (16.1% vs 10.5%) but not the HIV− group (4.3% vs 3.5%). HIV+ women performed worse compared to men on psychomotor speed, orientation, attention, and calculation, whereas HIV− women performed worse compared to men on attention and calculation. Adjusted interaction effects of HIV status × sex (women vs men) were significant on orientation, attention, and calculation, and marginally significant on psychomotor speed (p = 0.053). In multivariable models, among both HIV+ women and men, less years of education and depressive symptoms were associated with NCI. Waist-to-hip ratio above the cut-off was strongly associated with NCI among HIV+ women. HIV+ women perform worse on cognitive measures compared to HIV+ men. The association of central obesity with NCI in HIV+ women should be noted.

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Funding

This study was funded by the China National Science and Technology Major Projects on Infectious Diseases (grant number 2018ZX10721102-004) and the National Natural Science Foundation of China (grant numbers 81872671, 81803291) and partially supported by the Shanghai Municipal Health and Family Planning Commission (grant numbers GWTD2015S05, 15GWZK0101).

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Author notes

  1. Xiaotong Qiao and Haijiang Lin contributed equally to this work.

Authors and Affiliations

  1. Department of Epidemiology, School of Public Health, The Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, P.O.Box 289,138 Yi Xue Yuan Road, Shanghai, 200032, China

    Xiaotong Qiao, Chenxi Ning, Keran Wang, Xiaohui Xu, Xiaoyi Xu, Xing Liu, Na He & Yingying Ding

  2. Taizhou City Center for Disease Control and Prevention, Taizhou City, Zhejiang Province, China

    Haijiang Lin, Xiaoxiao Chen & Weiwei Shen

  3. Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai, China

    Xing Liu, Na He & Yingying Ding

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  1. Xiaotong Qiao
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  2. Haijiang Lin
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  3. Xiaoxiao Chen
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  4. Chenxi Ning
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  10. Na He
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  11. Yingying Ding
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Correspondence to Yingying Ding.

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Qiao, X., Lin, H., Chen, X. et al. Sex differences in neurocognitive screening among adults living with HIV in China. J. Neurovirol. 25, 363–371 (2019). https://doi.org/10.1007/s13365-019-00727-0

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