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Neurocognitive Complications of HIV Infection in Women: Insights from the WIHS Cohort

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Neurocognitive Complications of HIV-Infection

Part of the book series: Current Topics in Behavioral Neurosciences ((CTBN,volume 50))

Abstract

Although sex differences in brain function and brain disorders are well documented, very few studies have had adequate number of women to address sex-related factors contributing to HIV-associated brain dysfunction. Compared to men living with HIV (MLWH), women living with HIV (WLWH) may be at greater risk for cognitive dysfunction and decline due to biological factors (e.g., hormonal, immunologic) and issues common in underserved communities including poverty, low literacy levels, mental health and substance abuse, barriers to health-care services, and environmental exposures. To address this issue, we review relevant cross-sectional and longitudinal findings from the Women’s Interagency HIV Study (WIHS), the largest study of the natural and treated history of WLWH, as well as other studies focusing on cognitive complications of HIV in women. We provide evidence that WLWH are more cognitively vulnerable than MLWH and that there are differences in the pattern of cognitive impairment. We next discuss factors that contribute to these differences, including biological factors (e.g., inflammation, hormonal, genetic) as well as common comorbidities (mental health, substance use, vascular and metabolic risk factors, coinfections and liver function, non-antiretroviral medications, and genetic markers). These findings demonstrate the importance of considering sex as a biological factor in studies of cognitive dysfunction and suggest avenues for future research.

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Authors and Affiliations

  1. Department of Neurology and Psychiatry, Johns Hopkins School of Medicine, Baltimore, MD, USA

    Leah H. Rubin

  2. Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD, USA

    Leah H. Rubin

  3. Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA

    Pauline M. Maki

  4. Department of Psychology, University of Illinois at Chicago, Chicago, IL, USA

    Pauline M. Maki

Authors
  1. Leah H. Rubin
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  2. Pauline M. Maki
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Correspondence to Leah H. Rubin .

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Editors and Affiliations

  1. School of Psychology, The University of New South Wales, Sydney, NSW, Australia

    Lucette A. Cysique

  2. MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute St. Michael’s Hospital and Unity Health Toronto, Toronto, ON, Canada

    Sean B. Rourke

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Rubin, L.H., Maki, P.M. (2019). Neurocognitive Complications of HIV Infection in Women: Insights from the WIHS Cohort. In: Cysique, L.A., Rourke, S.B. (eds) Neurocognitive Complications of HIV-Infection. Current Topics in Behavioral Neurosciences, vol 50. Springer, Cham. https://doi.org/10.1007/7854_2019_101

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