CROI 2015 Program and Abstracts

Abstract Listing

Poster Abstracts

489 The Impact of Physical Activity on Cognition in MenWith andWithout HIV Anne Monroe 1 ; Long Zhang 7 ; Lisa P. Jacobson 7 ;ToddT. Brown 1 ; Michael Plankey 4 ; Eric Miller 3 ; JamesT. Becker 5 ; Eileen Martin 6 ; Ned Sacktor 1 On behalf of the Multicenter AIDS Cohort Study 1 Johns Hopkins University School of Medicine, Baltimore, MD, US; 2 Johns Hopkins University School of Medicine, Baltimore, MD, US; 3 University of California Los Angeles, Los Angeles, CA, US; 4 Georgetown University, Washington, DC, US; 5 University of Pittsburgh, Pittsburgh, PA, US; 6 Rush University Medical Center, Chicago, IL, US; 7 Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, US Background: HIV-associated neurocognitive disorder (HAND) is a highly prevalent complication of HIV infection, however, the mechanism of its development and its optimal treatments are only partially understood. Our objective was to determine the association between physical activity and cognitive function and the effect of HIV on that association among participants from the Multicenter AIDS Cohort Study (MACS). Methods: The International Physical Activity Questionnaire (IPAQ) short formwas administered during a semiannual MACS visit occuring from April 1, 2010 to March 31, 2011, serving as the baseline visit for this analysis. Metabolic Equivalents (METs) total score and categorical physical activity scores (low, moderate, and high) were generated. Assessments of psychomotor function (Symbol Digit Modalities Test (SDMT)), executive functioning (Trail Making Test Part B), and motor speed (Trail Making Test Part A) were performed at the baseline visit and at up to eight subsequent MACS visits. We determined the association between median test scores and physical activity, demographic, and clinical factors at the baseline visit and also examined the association between demographic and clinical factors and the change in test performance over time. Results: Of the 622 men included, 44%were HIV-infected. Low, moderate, and high activity was reported in 19%, 31% and 50% of the HIV-uninfected men and 28%, 25%, and 48% of the HIV-infected men, respectively. HIV was not significantly associated with SDMT, Trails A, or Trails B score in multivariate analysis. In the cross-sectional analysis, high physical activity category was associated with better SDMT and Trails B test scores compared with low activity ( β =0.45, p=0.02 and β =0.45, p=0.03) among all men and was associated with better SDMT scores when HIV-infected men were examined separately ( β =0.57, p=0.01). In the longitudinal analysis, physical activity category at baseline was not associated with subsequent change in SDMT, Trails A, or Trails B. Conclusions: Higher physical activity category was associated with better scores on tests of psychomotor and executive functioning in a cohort of HIV-infected and –uninfected men at baseline but did not affect the change over time. Physical activity may have protective effects against cognitive impairments, independent of HIV status. 490 Abnormal Lung Function AssociatedWith Abnormal Brain Structure and Function in HIV Alison Morris 1 ; Lawrence Kingsley 1 ; Matthew Gingo 1 ; Meghan Fitzpatrick 1 ; Roger Detels 3 ; Oto Martinez 3 ; Eric Miller 3 ; Jeffrey Alger 3 ; Eric Kleerup 3 ; JamesT. Becker 1 1 University of Pittsburgh, Pittsburgh, PA, US; 2 University of Pittsburgh, Pittsburgh, PA, US; 3 David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA, US Background: Cognitive deficits and alterations in brain structure are associated with chronic obstructive pulmonary disease. Both cognitive impairment and chronic obstructive pulmonary disease are non-AIDS-associated comorbidities that are increased in HIV-infected individuals, but whether lung function abnormalities have an additional impact on brain function in HIV is unknown. The purpose of this study was to determine the relationships among lung function, brain structure at the voxel level, and cognitive function and to determine whether these relationships are altered in HIV infection. Methods: 65 men participating in the Multicenter AIDS Cohort Study (55% HIV-infected) underwent measurement of lung function, brain structural magnetic resonance imaging, and neuropsychological testing. Pre-and post-bronchodilator spirometry and measurement of diffusion capacity of the lung for carbon monoxide (DLCO) were performed in accordance with American Thoracic Society standards. Standard reference equations for predicted values were used for spirometry and DLCO; DLCO was corrected for hemoglobin and carboxyhemoglobin. Three-dimensional anatomical brain images were segmented by tissue type, and the whole brain gray matter analyzed using Voxel-Based Morphometry. Multivariate models were constructed in Statistical Parametric Mapping (SPM8) to examine the impact of HIV and lung function on brain volume measured at the voxel level. The statistical threshold was set at p<.005 and 100 voxels. Results: The associations between DLCO and brain structure are shown in Figure 1 overlaid onto the MACS MRI template (MRIcron); the affected Grey Matter included the ventral putamen including the basal forebrain, and the affected White Matter included the pregenual part of the cingulum. Linear regression analyses found no significant interactions between lung function, smoking and HIV in predicting GM volume of the ventral putamen. Lower diffusion capacity was associated with a worse cognitive summary score (Beta=.37, p=.005), independent of HIV infection (Beta=.11).

Poster Abstracts

Conclusions: We report here, for the first time, on the relationship between lung function impairment and abnormal brain structure. In addition, we report on the relationship between these lung function and cognition in this group of study participants

328

CROI 2015