Cognitive changes in patient living with HIV-AIDS and apolipoprotein-E polymorphism: is there an association?
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ORIGINAL ARTICLE
Cognitive changes in patient living with HIV‑AIDS and apolipoprotein‑E polymorphism: is there an association? P. R. Brito‑Marques1,2 · P. A. S. Rocha‑Filho2,3 · E. Dellalibera2 · M. T. C. Muniz2 · C. Cunha‑Correia1,2 Received: 20 July 2020 / Revised: 11 October 2020 / Accepted: 13 October 2020 © Springer Nature B.V. 2020
Abstract Patients with HIV-AIDS treated with antiretroviral drugs still have high prevalence of cognitive disorders and many factors are likely to contribute for ongoing neurologic decline such as chronic low-level infection, coinfections with hepatitis B and C and genetic influences, both the virus and the host. Some evidences suggest that the genetic APOE polymorphism may be an associated risk factor. This study aimed to evaluate the association between APOE polymorphisms and cognitive disorders in patients with HIV-AIDS. This was a cross-sectional study comprising 133 patients aged 19–59 years old, with HIV-AIDS and were assisted at the infectious disease outpatient clinics at Hospital Universitário Oswaldo Cruz, in Recife, Brazil. For cognitive evaluation, Mini-Mental State Examination test (MMSE) and Montreal Cognitive Assessment test (MoCA) were used. The determination of APOE gene polymorphism was performed by using the PCR-RFLP technique. Sociodemographic and clinical characteristics were not significantly associated to APOE ε4 polymorphism, except for the high results of CD4 rate (p 30 minutes during the last 6 months; presence of severe neurological or psychiatric conditions that may interfere with the results of this study; hepatitis C carrier, neurosyphilis, and decompensated diabetes mellitus; or other clinical disease that interfere with the cognitive test results. The patients were evaluated by a neurologist specialized in cognitive disorders. This neurologist was unaware of APOE gene polymorphism status in these patients. The patients were interviewed by a semi-structured questionnaire that included sociodemographic and, clinical data such as smoking, HIV diagnosis time, serum CD4 level, viral load and presence of comorbidities such as dyslipidemia, systemic arterial hypertension, diabetes mellitus.
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Molecular Biology Reports
Cognitive screening During the interview, the patients were lucid, although they had cognitive complaints in various intensity, especially due to anterograde amnesia. A low percentage of patients had some degree of activity dependence in their daily lives, in addition to anterograde amnesia. After the interview, the Mini-Mental State Examination test (MMSE) was performed, respecting schooling level [16], and the Montreal Cognitive Assessment test (MoCA) [17–19], both of these tests were according to their respective cutoff points, 25 and 23, respectively. MMSE is the most used screening test in clinics for easy access, rapid and basic information [16]. MoCA is a more elaborated test than MMSE, and it can reach cognition details as a brief screening tool for mild cognitive impairment [17]. Depressive symptoms were assessed by using the
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