APOE Genotype is not related to Neurocognitive Function in HIV: CHARTER Analysis.

Type: Published Abstract
Title: APOE Genotype is not related to Neurocognitive Function in HIV: CHARTER Analysis.
Authors: Clifford D, Morgan E, Vaida F, Heaton R, Goate A, Bloss C, Marra C, Ances B, Collier A, Gelman B, McArthur J, Morgello S, Letendre S, Grant I, for the CHARTER Study
Year: 2011
Publication: 6th IAS Conference on HIV Pathogenesis, Treatment and Prevention, July 17-20, Rome, Italy
Volume: Issue: Pages:
Abstract:Background: Apolipoprotein E4 alleles are very strong risk factors for development of Alzheimer's disease (AD), and their presence may exacerbate other forms of neurological injury. Several studies in HIV have shown inconsistent associations between APOE genotype and HIV associated neurocognitive disorder(HAND). Recent descriptions of similar CSF amyloid concentrations in AD and HIV associated dementia (HAD) along with concerns that HIV may cause accelerated aging, including earlier manifestation of neurodegenerative disease, all support the importance of understanding APOE's impact on HAND. We hypothesized HIV-seropositive APOE4 carriers when compared to those without APOE4 alleles are at increased risk for HAND. Methods: APOE genotype was determined for 468 patients in the CNS HIV Antiretroviral Therapy Effects Research (CHARTER) cohort who did not have severe psychiatric or medical confounds.. Neurocognitive impairment (NCI) and HAND diagnoses were based on results of comprehensive neuropsychological testing as previously described (Heaton, et al., Neurology, 2010) Results: Mean age was 44.1 yr. 145 (31%) carried APOE4 alleles. Separate multiple linear regression analyses predicting NCI and HAND revealed no main effect of APOE4 carrier status and no interaction with ethnicity, age, substance use disorders, duration of infection, or nadir CD4. NCI and HAD was not predicted by whether patients had one or two APOE4 alleles. Conclusion: APOE4 status is not associated with impaired neurocognition in a large, well characterized sample of patients receiving HIV care in the United States. This outcome does not preclude emergence of an association of impairment with APOE4 status as this population ages. CSF amyloid changes precede cognitive impairment by as much as 20 years in AD. Future studies will focus on APOE status and CSF amyloid status, as well as longitudinal changes in cognitive performance with aging.