Sustained attention and vigilance deficits associated with HIV and a history of methamphetamine dependence

• Published in: Drug and alcohol dependence Vol. 215; p. 108245
• Main Authors: Pocuca, Nina, Young, Jared W., MacQueen, David A., Letendre, Scott, Heaton, Robert K., Geyer, Mark A., Perry, William, Grant, Igor, Minassian, Arpi
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier B.V 01.10.2020; Elsevier Science Ltd
• Subjects: Acquired immune deficiency syndrome; Adult; AIDS; Amphetamine-Related Disorders - epidemiology; Amphetamine-Related Disorders - psychology; Antiretroviral agents; Antiretroviral therapy; Attention - drug effects; Central Nervous System Stimulants - pharmacology; Cerebrospinal fluid; Cognition; Cognition - drug effects; Cognitive ability; Cognitive impairment; Continuous performance test; Dependence; Diagnosis; Drug therapy; Female; HIV; HIV Infections - psychology; Human immunodeficiency virus; Humans; Impairment; Male; Males; Medical diagnosis; Methamphetamine; Methamphetamine - pharmacology; Middle Aged; Neurocognitive Disorders; Performance tests; Reaction time; Reaction Time - drug effects; Research facilities; Sustained attention; Therapy; Toxicology; Vigilance; Viral Load; Viruses; Young Adult; Vigilance; Sustained attention; Human immunodeficiency virus; Continuous performance test; Methamphetamine
• ISSN: 0376-8716; 1879-0046
• DOI: 10.1016/j.drugalcdep.2020.108245

•Methamphetamine dependence (METH) impaired sustained attention and vigilance.•METH was unassociated with impairments after removing recent methamphetamine users.•Viral load suppression (VLS) was associated with better vigilance.•Human immunodeficiency virus (HIV) was associated with psychomotor slowing.•HIV was not associated with sustained attention and vigilance. Human immunodeficiency virus (HIV)-associated neurocognitive disorders persist in the era of antiretroviral therapy. One factor that is elevated among persons with HIV (PWH) and independently associated with neurocognitive impairment is methamphetamine dependence (METH). Such dependence may further increase cognitive impairment among PWH, by delaying HIV diagnosis (and thus, antiretroviral therapy initiation), which has been posited to account for persistent cognitive impairment among PWH, despite subsequent treatment-related viral load suppression (VLS; <50 copies of the virus per milliliter in plasma or cerebrospinal fluid). This study examined the main and interactive (additive versus synergistic) effects of HIV and history of METH on the sustained attention and vigilance cognitive domain, while controlling for VLS. Participants included 205 (median age = 44 years; 77% males; HIV-/METH- n = 67; HIV+/METH - n = 49; HIV-/METH+ n = 36; HIV+/METH+ n = 53) individuals enrolled in the Translational Methamphetamine AIDS Research Center, who completed Conners’ and the 5-Choice continuous performance tests (CPTs). METH participants exhibited deficits in sustained attention and vigilance; however, these effects were not significant after excluding participants who had a positive urine toxicology screen for methamphetamine. Controlling for VLS, PWH did not have worse sustained attention and vigilance, but consistently displayed slower reaction times across blocks, relative to HIV- participants. There was no HIV x METH interaction on sustained attention and vigilance. Recent methamphetamine use among METH people and detectable viral loads are detrimental to sustained attention and vigilance. These findings highlight the need for prompt diagnosis of HIV and initiation of antiretroviral therapy, and METH use interventions.