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Switch On Your HIV Smarts.

For people with HIV, higher HDL cholesterol linked to improved cognition

, by Emily Newman

BETA is attending and reporting from the 2017 International AIDS Society conference on HIV Science this week in Paris, France from July 23 to 26—bringing you the latest news, updates, and research on HIV treatment and prevention.

In a session at the IAS 2017 conference about growing older with HIV, Felicia Chow, MD, from the University of California, San Francisco presented research linking HDL cholesterol (the “good” cholesterol) to reduced risk of cognitive decline. In a sample of about 1,000 middle-age and older adults living with HIV, Chow and colleagues found that each 10 mg/dL increase in HDL reduced the risk of cognitive impairment by 11%—and and that this was independent of other cardiovascular risk factors, demographic information and HIV-related factors (like viral load and CD4 count).

The next step, said Chow, is to find out if interventions that raise HDL improve or protect cognitive function in people living with HIV. And, if increasing HDL is protective, when the best time in a person’s life is to implement such interventions.

Felicia Chow

Felicia Chow, MD

“Exercise is one intervention to raise HDL—diet as well. Smoking cessation is associated with an increase in HDL, and there are certain medications that can increase HDL,” said Chow. “Diet and exercise are things that certainly work, and can lead to a rise in HDL. At least, that’s a place to start.”

The study presented by Chow included data from the HIV, Aging and Immune Function Long-Term Observational (HAILO) Study, with health and demographic information from 988 people living with HIV. Most (80%) were men, about 50% were non-white, 90% were virally suppressed and most (60%) had more than a high school education. A third of the group were on antihypertensive (blood pressure) medication, 27% were taking a statin drug and the mean HDL was 49 (mg/dL).

To measure cognitive impairment, the researchers looked at scores on four separate tests measuring things like thinking and memory that were part of a neurocognitive screen in the HAILO study. They then used a regression model to determine if there was any association between cognitive impairment and these other factors.

In the study, people who were older, who were women, who were Hispanic/Latino, or who used an antidepressant or an integrase inhibitor were at higher risk of cognitive impairment. The only cardiovascular factor associated with cognitive impairment was HDL.

Having an HDL greater than 50 mg/dL reduced the odds of cognitive impairment by 35%. An HDL greater than 60 mg/dL reduced the odds of cognitive impairment by 45%.

Want to learn more about HIV and its effects on the brain? Read more from neurologist Joanna Hellmuth, MD, MHS on BETA, including her advice for how to prevent HIV-related cognitive changes as you age and what to do if you start to notice any changes in your thinking or memory.  

Source

Akintomiwa, M. and colleagues. Higher HDL, better brain? Higher HDL cholesterol is associated with better cognition in a cohort of older persons living with HIV infection.  IAS 2017, Abstract 4357.

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