Tryptophan degradation is associated with risk-taking propensity in methamphetamine users with treated HIV infection
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Tryptophan degradation is associated with risk-taking propensity in methamphetamine users with treated HIV infection Jared Lee 1 & Ji-Young Lee 1 & Christina S. Meade 2 & Michael Cohn 3 & Antonio Chahine 1 & Samantha E. Dilworth 3 & Jessica F. Magidson 4 & Hetta Gouse 5 & Dietmar Fuchs 6 & Adam W. Carrico 1 Received: 4 January 2020 / Revised: 11 March 2020 / Accepted: 13 April 2020 # Journal of NeuroVirology, Inc. 2020
Abstract Few studies have examined neuroimmune pathways that could contribute to impulsivity in people living with HIV who use substances. Eighty-four methamphetamine-using, sexual minority men with an undetectable HIV viral load were administered the Balloon Analogue Risk Task (BART), a behavioral measure of risk-taking propensity. We examined the associations between kynurenine/tryptophan ratio and phenylalanine/tyrosine ratio with BART scores using multiple linear regression. A higher kynurenine/tryptophan ratio was independently associated with greater BART scores (beta = 0.25; 95% CI = 0.05–1.23; p = 0.034). The phenylalanine/tyrosine ratio was not significantly associated with BART scores. Findings support the need for further research to elucidate the neuroimmune mechanisms linking tryptophan degradation with impulsivity to catalyze the development novel pharmacologic treatments for people living with HIV who use methamphetamine. Keywords HIV . Risk-taking propensity . Impulsivity . Methamphetamine . Tryptophan
Introduction The use of methamphetamine and other amphetamine-type stimulants has been a growing comorbidity among people with HIV (Gamarel et al. 2016). This is particularly true among sexual minority men (i.e., gay, bisexual, and other men who have sex with men) where prevalence estimates are between 7.2 and 18.8% (Hickson et al. 2007; Koblin et al. 2007). More frequent stimulant users also experience difficulties along the HIV care continuum as * Adam W. Carrico [email protected] 1
Public Health Sciences and Psychology, Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120NW 14th St. Office 1005, Miami, FL 33136, USA
2
Duke University School of Medicine, Durham, NC, USA
3
University of California, San Francisco School of Medicine, San Francisco, CA, USA
4
University of Maryland Department of Psychology, College Park, MD, USA
5
Unviversity of Cape Town Department of Psychiatry and Mental Health, Cape Town, South Africa
6
Innsbruck Medical University, Innsbruck, Austria
well as display faster clinical HIV progression (Carrico et al. 2011; Carrico et al. 2014; Cook et al. 2008). Inextricably linked to methamphetamine use is the comorbid behavioral trait of impulsivity. Impulsivity has not only been cited as a moderator that facilitates both methamphetamine use and condomless sex among sexual minority men living with HIV (Semple et al. 2006) but has also been associated with bodily and interpersonal self-harm (Chamberlain et al. 2017). Because impulsivity is an important risk factor in the development and maintenanc
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