Alcohol consumption and neurocognitive deficits in people with well-treated HIV in Switzerland

Katharine E A Darling; Isabella Locatelli; Nadia Benghalem; Isaure Nadin; Alexandra Calmy; Klemens Gutbrod; Christoph Hauser; Peter Brugger; Barbara Hasse; Helen Kovari; Ursi Kunze; Marcel Stoeckle; Christophe Fux; Stefania Rossi; Caroline Di Benedetto; Severin Früh; Patrick Schmid; Philip E Tarr; Jean-Bernard Daeppen; Renaud Du Pasquier; Matthias Cavassini; NAMACO Study Group, Swiss HIV Cohort Study

doi:10.1371/journal.pone.0246579

Alcohol consumption and neurocognitive deficits in people with well-treated HIV in Switzerland

PLoS One. 2021 Mar 2;16(3):e0246579. doi: 10.1371/journal.pone.0246579. eCollection 2021.

Authors

Katharine E A Darling¹, Isabella Locatelli², Nadia Benghalem¹, Isaure Nadin³, Alexandra Calmy⁴, Klemens Gutbrod⁵, Christoph Hauser⁶, Peter Brugger⁷, Barbara Hasse⁸, Helen Kovari⁸, Ursi Kunze⁹, Marcel Stoeckle¹⁰, Christophe Fux¹¹, Stefania Rossi¹², Caroline Di Benedetto¹³, Severin Früh¹⁴, Patrick Schmid¹⁵, Philip E Tarr¹⁶, Jean-Bernard Daeppen¹⁷, Renaud Du Pasquier¹⁸, Matthias Cavassini¹; NAMACO Study Group, Swiss HIV Cohort Study

Affiliations

¹ Infectious Diseases Service, Lausanne University Hospital, Lausanne, Switzerland.
² Division of Biostatistics and Quantitative Methods, Institute of Social and Preventive Medicine, Lausanne University Hospital, Lausanne, Switzerland.
³ Department of Clinical Neurosciences, Laboratory of Neuroimmunology, Research Centre of Clinical Neurosciences, Lausanne University Hospital, Lausanne, Switzerland.
⁴ HIV Unit, Infectious Diseases Division, Medicine Specialties Department, Geneva University Hospital, University of Geneva, Geneva, Switzerland.
⁵ Division of Cognitive and Restorative Neurology, Department of Neurology, Inselspital Bern, Bern, Switzerland.
⁶ Department of Infectious Diseases, Bern University Hospital, University of Bern, Bern, Switzerland.
⁷ Department of Neuropsychology, Neurology Clinic, University Hospital Zürich, Zürich, Switzerland.
⁸ Department of Infectious Diseases and Hospital Epidemiology, Universitätsspital Zurich, University of Zurich, Zurich, Switzerland.
⁹ Memory Clinic, Felix Platter Hospital, University Centre for Medicine of Aging, Basel, Switzerland.
¹⁰ Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, University of Basel, Basel, Switzerland.
¹¹ Infectious Diseases and Hospital Epidemiology Department, Kantonsspital Aarau, Aarau, Switzerland.
¹² Neuropsychology Unit, Lugano Regional Hospital, Lugano, Switzerland.
¹³ Infectious Diseases Division, Lugano Regional Hospital, Lugano, Switzerland.
¹⁴ Neuropsychology Unit, Department of Neurology, Kantonsspital St. Gallen, St. Gallen, Switzerland.
¹⁵ Infectious Diseases and Hospital Epidemiology Division, Kantonsspital St. Gallen, St. Gallen, Switzerland.
¹⁶ University Department of Medicine, Kantonsspital Bruderholz, University of Basel, Bruderholz, Switzerland.
¹⁷ Service of Addiction Medicine, Lausanne University Hospital, Lausanne, Switzerland.
¹⁸ Service of Neurology, Department of clinical neurosciences, Lausanne University Hospital, Lausanne, Switzerland.

Abstract

Background: Hazardous alcohol consumption and HIV infection increase the risk of neurocognitive impairment (NCI). We examined the association between alcohol consumption and specific neurocognitive domain function in people with HIV (PWH) taking modern antiretroviral therapy.

Methods: The Neurocognitive Assessment in the Metabolic and Aging Cohort (NAMACO) study is a prospective, longitudinal, multicentre and multilingual (French, German and Italian) study of patients aged ≥45 years old enrolled in the Swiss HIV Cohort Study (SHCS). Baseline data from 981 study participants were examined. Five neurocognitive domains were evaluated: motor skills, speed of information processing, attention/working memory, executive function and verbal episodic memory. NCI was examined as binary (presence/absence) and continuous (mean z-score) outcomes against Alcohol Use Disorders Identification Test for Consumption (AUDIT-C) scores using logistic and linear regression models, respectively.

Results: Most participants (96.2%) had undetectable viral loads and 64% were aged >50 years old. Hazardous alcohol consumption was observed in 49.4% of participants and binge drinking in 4.2%. While alcohol consumption frequency and quantity were not associated with NCI, the practice of binge drinking was significantly associated with impaired motor skills and overall neurocognitive function in both binary (odds ratio, OR ≥2.0, P <0.05) and continuous (mean z-score difference -0.2 to -0.4, P ≤0.01) outcomes. A significant U-shaped distribution of AUDIT-C score was also observed for motor skills and overall neurocognitive function.

Conclusions: In this cohort of PWH with well-controlled HIV infection, NCI was associated with the practice of binge drinking rather than alcohol consumption frequency or quantity. Longitudinal analysis of alcohol consumption and NCI in this population is currently underway.

Publication types

Multicenter Study
Research Support, Non-U.S. Gov't

MeSH terms

Aged
Alcohol Drinking / epidemiology*
Alcohol Drinking / psychology
Anti-Retroviral Agents / therapeutic use*
Female
HIV Infections / drug therapy*
HIV Infections / psychology
Humans
Logistic Models
Longitudinal Studies
Male
Mental Processes
Middle Aged
Neurocognitive Disorders / diagnosis*
Neurocognitive Disorders / etiology
Prospective Studies
Switzerland

Substances

Anti-Retroviral Agents

Grants and funding

This work was supported by the Swiss National Science Foundation (grant number 163348) and the Swiss HIV Cohort Study (grant number 177499, project 811). Additional funding has been provided by the Swiss HIV Cohort foundation and ViiV Healthcare. The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.