Chapter 33 : Interaction of the Aging Process with Neurobehavioral and Neuro-AIDS Conditions in the HAART Era

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Interaction of the Aging Process with Neurobehavioral and Neuro-AIDS Conditions in the HAART Era, Page 1 of 2

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The foregoing introduction to the epidemiology of aging in HIV-1 infection leads us to an important preliminary conclusion. That is, the study of older age in HIV-1 infection is more properly considered as (i) the study of a population of newly infected older individuals and (ii) the study of a separate group of long-term HIV-1-infected patients successfully treated with highly active antiretroviral (ARV) therapy (HAART). The authors used a generalized linear models approach with age category, HIV-1 disease category (HIV-1 seronegative, CDC stage B/early symptomatic HIV-1 infection, and CDC stage C/AIDS), and their interaction as predictors of the total number of MCMD symptoms (zero to six) defined by the American Academy of Neurology. Given the hypercortisolemia-induced neuronal cellular toxicity associated with major depressive disorder and with chronic stressor exposure, both of these conditions may enhance the likelihood of neurocognitive impairment (NCI) and neurocognitive disorder when superimposed upon the toxicities associated with the aging process and HIV-1 infection of the brain. In addition to the consideration of how aging might interact with HIV-1 infection in specific neuro-AIDS conditions, an overarching issue exists. That issue is related to how an increased frequency of medical comorbidities might interact with aging in the likelihood of expression of neuro-AIDS conditions.

Citation: Goodkin K, Concha M, Jamieson B, Molina R, Lopez E, Zheng W, Asthana D, Hardy W. 2009. Interaction of the Aging Process with Neurobehavioral and Neuro-AIDS Conditions in the HAART Era, p 473-486. In Goodkin K, Shapshak P, Verma A (ed), The Spectrum of Neuro-AIDS Disorders. ASM Press, Washington, DC. doi: 10.1128/9781555815691.ch33

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The overlap of two populations, older persons and the HIV-1 infected, has been increasing in recent years. A third population, those with NCI, normally significantly overlaps each of these populations independently. In the intersection of those with older age and those with HIV infection, the area of such overlap is expected to be proportionately greater. In association with this overlap, it is expected that there will be a high rate of decrements of functional status in the activities of daily living that are most closely related to NCI. In turn, it is expected that there will be proportionately higher rates of the HIV-1-associated neurocognitive disorders (MCMD and HAD). These disorders relate particularly well to anticipated immunological changes occurring in this overlap group—decreases in naive CD4 cell counts and increases in the activation state of CD8 cells, as well as in the secretion of proinflammatory cytokines (TNF-α, IL-1, and IL-6). These immunological changes are expected to be associated with virologic changes characterized by an increase in the elaboration of neurotoxic viral proteins (gp120 and Tat).

Citation: Goodkin K, Concha M, Jamieson B, Molina R, Lopez E, Zheng W, Asthana D, Hardy W. 2009. Interaction of the Aging Process with Neurobehavioral and Neuro-AIDS Conditions in the HAART Era, p 473-486. In Goodkin K, Shapshak P, Verma A (ed), The Spectrum of Neuro-AIDS Disorders. ASM Press, Washington, DC. doi: 10.1128/9781555815691.ch33
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1. American Academy of Neurology. 1991. Nomenclature and research case definitions for neurological manifestations of human immunodeficiency virus type-1 (HIV-1) infection. Neurology 41:778785.
2. Anthony, I. C.,, S. N. Ramage,, F. W. Carnie,, P. Simmonds, and, J. E. Bell. 2006. Accelerated Tau deposition in the brains of individuals infected with human immunodeficiency virus-1 before and after the advent of highly active antiretroviral therapy. Acta Neuropathologica 111:529538.
3. Antinori, A.,, G. Arendt,, J. T. Becker,, B. J. Brew,, D. A. Byrd,, M. Cherner,, D. B. Clifford,, P. Cinque,, L. G. Epstein,, K. Goodkin,, M. Gisslen,, I. Grant,, R. K. Heaton,, J. Joseph,, K. Marder,, C. M. Marra,, J. C. McArthur,, M. Nunn,, R. W. Price,, L. Pulliam,, K. R. Robertson,, N. Sacktor,, V. Valcour, and, V. E. Wojna. 2007. Updated research nosology for HIV-associated neurocognitive disorders. Neurology 69:17891799.
4. Archibald, S. L.,, E. Masliah,, C. Fennema-Notestine,, T. D. Marcotte,, R. J. Ellis,, J. A. McCutchan,, R. K. Heaton,, I. Grant,, M. Mallory,, A. Miller, and, T. L. Jernigan. 2004. Correlation of in vivo neuroimaging abnormalities with postmortem human immunodeficiency virus encephalitis and dendritic loss. Arch. Neurol. 61:369376.
5. Arien, K. K.,, G. Vanham, and, E. J. Arts. 2007. Is HIV-1 evolving to a less virulent form in humans? Nat. Rev. Microbiol. 5:141151.
6. Baddeley A. 1992. Working memory. Science 255:556559.
7. Baillargeon, J.,, M. Borucki,, S. A. Black, and, K. Dunn. 1999. Determinants of survival in HIV-positive patients. Int. J. STD AIDS 10:2227.
8. Banks, W. A.,, S. M. Robinson, and, A. Nath. 2005. Permeability of the blood-brain barrier to HIV-1 Tat. Exp. Neurol. 193:218227.
9. Barger, S. W.,, and L. J. van Eldik. 1992. S100β stimulates calcium fluxes in glial and neuronal cells. J. Biol. Chem. 267:96899694.
10. Berger, J. R.,, and M. Concha. 1995. Progressive multifocal leukoencephalopathy: the evolution of a disease once considered rare. J. Neurovirol. 1:518.
11. Bonnet, F.,, C. Lewden,, T. May,, L. Heripret,, E. Jougla,, S. Bevilacqua,, D. Costagliola,, D. Salmon,, G. Chene, and, P. Morlat. 2004. Malignancy-related causes of death in human immunodeficiency virus-infected patients in the era of highly active antiretroviral therapy. Cancer 101:317324.
12. Butt, A. A.,, K. K. Dascomb,, K. B. DeSalvo,, L. Bazzano,, P. J. Kissinger, and, H. M. Szerlip. 2001. Human immunodeficiency virus infection in elderly patients. South. Med. J. 94:397400.
13. Centers for Disease Control and Prevention. 2007. Cases of HIV infection and AIDS in the United States and dependent areas, 2005. HIV/AIDS Surveillance Report vol. 17, revised ed.
14. Chiesi, A.,, S. Vella,, L. G. Dally,, C. Pedersen,, S. Danner,, A. M. Johnson,, S. Schwander,, F. D. Goebel,, M. Glauser,, F. Antunes, and, J. D. Lundgrenfor the AIDS in Europe Study Group. 1996. Epidemiology of AIDS dementia complex in Europe. J. AIDS Hum. Retrovirol. 11:3944.
15. Clifford, D. B.,, S. Evans,, Y. Yang,, E. P. Acosta,, K. Goodkin,, K. Tashima,, D. Simpson,, D. Dorfman,, H. Ribaudo,and R. M. Gulick for the A5097s Study Team. 2005. Impact of efavirenz on neuropsychological performance and symptoms in HIV-infected individuals. Ann. Intern. Med. 143:714721.
16. Clifford, D. B.,, C. Yiannoutsos,, M. Glicksman,, D. M. Simpson,, E. J. Singer,, P. J. Piliero,, C. M. Marra,, G. S. Francis,, J. C. McArthur,, K. L. Tyler,, A. C. Tselis, and, N. E. Hyslop. 1999. HAART improves prognosis in HIV-associated progressive multifocal leukoencephalopathy. Neurology 52:623625.
17. Cornblath, D. R.,, and A. Hoke. 2006. Recent advances in HIV neuropathy. Curr. Opin. Neurol. 19:446450.
18. Darby, S. C.,, S. W. Kan,, R. J. Spooner,, P. L. Giangrande,, C. A. Lee,, M. Makris,, C. A. Sabin,, H. G. Watson,, J. T. Wilde,, M. Winter,and the UK Haemophilia Centre Doctors’ Organisation. 2004. The impact of HIV on mortality rates in the complete UK haemophilia population. AIDS 18:525533.
19. Diaz, M.,, D. C. Douek,, H. Valdez,, B. J. Hill,, D. Peterson,, I. Sanne,, P. J. Piliero,, R. A. Koup,, S. B. Green,, S. Schnittman, and, M. M. Lederman. 2003. T cells containing T cell receptor excision circles are inversely related to HIV replication and are selectively and rapidly released into circulation with antiretroviral treatment. AIDS 17:11451149.
20. Effros, R. B. 2003. Replicative senescence: the final stage of memory T cell differentiation? Curr. HIV Res. 1:153165.
21. Ellis, R. J.,, R. Deutsch,, R. K. Heaton,, T. Marcotte,, J. A. McCutchan,, J. Nelson,, I. Abramson,, L. J. Thal,, J. H. Atkinson,, M. R. Wallace,, I. Grant,and the HIV Neurobehavioral Research Center Group. 1997. Neurocognitive impairment is an independent risk factor for death in HIV infection. Arch. Neurol. 54:416424.
22. Elphick, G. F.,, W. Querbes,, J. A. Jordan,, G. V. Gee,, S. Eash,, K. Manley,, A. Dugan,, M. Stanifer,, A. Bhatnagar,, W. K. Kroeze,, B. L. Roth, and, W. J. Atwood. 2004. The human polyomavirus, JCV, uses serotonin receptors to infect cells. Science 306:13801383.
23. Engels, E. A. 2001. Human immunodeficiency virus infection, aging, and cancer. J. Clin. Epidemiol. 54(Suppl. 1):S29S34.
24. Evers, S.,, D. Nabavi,, A. Rahmann,, C. Heese,, D. Reichelt, and, I. W. Husstedt. 2003. Ischaemic cerebrovascular events in HIV infection: a cohort study. Cerebrovasc. Dis. 15:199205.
25. Finch, C. E.,, and T. E. Morgan. 2007. Systemic inflammation, infection, ApoE alleles, and Alzheimer disease: a position paper. Curr. Alzheimer Res. 4:185189.
26. Florida State Department of Health. 2007. Florida Division of Disease Control Surveillance Report no. 272, p. 28, Table 5. Florida State Department of Health, Tallahassee, FL.
27. Franceschi, C.,, D. Monti,, D. Barbieri,, S. Salvioli,, E. Grassilli,, M. Capri,, L. Troiano,, M. Guido,, M. Bonafè,, F. Tropea,, P. Salomoni,, F. Benatti,, E. Bellesia,, S. Macchioni,, R. Anderlini,, P. Sansoni,, S. Mariotti,, M. L. Wratten,, C. Tetta, and, A. Cossarizza. 1996. Successful immunosenescence and the remodelling of immune responses with ageing. Nephrol. Dial. Transplant. 11(Suppl. 9):1825.
28. Fuller, G. N.,, J. M. Jacobs, and, R. J. Guiloff. 1991. Subclinical peripheral nerve involvement in AIDS: an electrophysiological and pathological study. J. Neurol. Neurosurg. Psychiatry 54:318324.
29. Ghani, A. C.,, C. A. Donnelly, and, R. M. Anderson. 2003. Patterns of antiretroviral use in the United States of America: analysis of three observational databases. HIV Med. 4:2432.
30. Goodkin, K.,, F. L. Wilkie,, A. Ardila,, D. Lee,, R. R. Molina,, D. Asthana,, P. Shapshak,, A. Frasca,, S. O’Mellan,, W. Zheng, and, I. Khamis. 2004. Older age and functional status in HIV+ and HIV- primary Spanish speakers in the USA (#MoPeB3368), p. 57. In CONGREX Sweden AB (ed.), Abstr. XVth Int. Conf. AIDS, 11–16 July 2004, Bangkok, Thailand. International AIDS Society, Stockholm, Sweden.
31. Goodkin, K.,, T. Heckman,, K. Siegel,, N. Linsk,, I. Khamis,, D. Lee,, R. Lecusay,, C. C. Poindexter,, S. J. Mason,, P. Suarez, and, C. Eisdorfer. 2003. “Putting a face” on HIV infection/AIDS in older adults: a psychosocial context. J. AIDS 33(Suppl. 2):S171S184.
32. Goodkin, K. 2002. Evolution of neuro-AIDS during the HAART era. J. Neuro-AIDS 2:117.
33. Goodkin, K.,, F. L. Wilkie,, M. Concha,, C. H. Hinkin,, S. Symes,, T. T. Baldewicz,, D. Asthana,, R. K. Fujimura,, D. Lee,, M. H. van Zuilen,, I. Khamis,, P. Shapshak, and, C. Eisdorfer. 2001. Aging and neuro-AIDS conditions: a potential interaction with the changing spectrum of HIV-1 associated morbidity and mortality in the era of HAART? J. Clin. Epidemiol. 54(Suppl. 1):S35S43.
34. Grulich, A. E. 1999. AIDS-associated non-Hodgkins lymphoma in the era of highly active antiretroviral therapy. J. Acquir. Immun. Defic. Syndr. 21(Suppl. 1):S27S30.
35. Hardy, D. J.,, C. H. Hinkin,, P. K. Stenquist,, W. G. van Gorp,, L. Moore, and, P. Satz. 1999. Age differences and neurocognitive performance in HIV-infected adults. N. Z. J. Psychol. 28:94101.
36. Heaton, R. K.,, R. A. Velin,, J. A. McCutchan,, S. J. Gulevich,, J. H. Atkinson,, M. R. Wallace,, H. P. Godfrey,, D. A. Kirson, and, I. Grant. 1994. Neuropsychological impairment in human immunodeficiency virus-infection: implications for employment. Psychosomat. Med. 56:817.
37. Hinkin, C. H.,, S. A. Castellon,, J. H. Atkinson, and, K. Goodkin. 2001. Neuropsychiatric aspects of HIV infection older adults. J. Clin. Epidemiol. 54(Suppl. 1):S44S52.
38. Huang, Y.,, N. Erdmann,, H. Peng,, Y. Zhao, and, J. Zheng. 2005. The role of TNF related apoptosis-inducing ligand in neurodegenerative diseases. Cell. Mol. Immunol. 2:113122.
39. Inungu, J. N.,, E. D. Mokotoff, and, J. B. Kent. 2001. Characteristics of HIV infection in patients fifty years or older in Michigan. AIDS Patient Care STDs 15:567573.
40. Jackola, D. R.,, J. K. Ruger, and, R. A. Miller. 1994. Age-associated changes in human T cell phenotype and function. Aging Clin. Exp. Res. 6:2534.
41. Janssen, R. S.,, O. C. Nwanyanwu,, R. M. Selik, and, J. K. Stehr-Green. 1992. Epidemiology of human immunodeficiency virus encephalopathy in the United States. Neurology 42:14721476.
42. Keller, M. J.,, J. M. Hausdorff,, L. Kyne, and, J. Y. Wei. 1999. Is age a negative prognostic indicator in HIV infection or AIDS? Aging 11:3538.
43. Kieburtz, K. D.,, L. Ketonen,, A. E. Zettelmaier,, D. Kido,, E. D. Caine, and, J. H. Simon. 1990. Magnetic resonance imaging findings in HIV cognitive impairment. Arch. Neurol. 47:643645.
44. Knippels, H. M. A.,, K. Goodkin,, J. J. Weiss,, F. L. Wilkie, and, M. H. Antoni. 2002. The importance of cognitive self-report in early HIV-1 infection: validation of a cognitive functional status subscale. AIDS 16:259267.
45. Korbo, L.,, and M. West. 2000. No loss of hippocampal neurons in AIDS patients. Acta Neuropathol. 99:529533.
46. Kramer-Hammerle, S.,, I. Rothenaigner,, H. Wolff,, J. E. Bell, and, R. Brack-Werner. 2005. Cells of the central nervous system as targets and reservoirs of the human immunodeficiency virus. Virus Res. 111:194213.
47. Larussa, D.,, P. Lorenzini,, A. Cingolani,, S. Bossolasco,, S. Grisetti,, M. Bongiovanni,, F. Moretti,, I. Uccella,, P. Zannoni,, S. Foresti,, G. Mazzarello,, M. I. Arcidiacono,, R. Pedale,, A. Ammassari,, V. Tozzi,, C. F. Perno,, A. D. Monforte,, P. Cinque,, A. Antinori,and the Italian Registry Investigative Neuro AIDS (IRINA). 2006. Highly active antiretroviral therapy reduces the age-associated risk of dementia in a cohort of older HIV-1-infected patients. AIDS Res. Hum. Retrovir. 22:386392.
48. Leitner, J. M.,, H. Pernerstorfer-Schoen,, A. Weiss,, K. Schindler,, A. Rieger, and, B. Jilma. 2006. Age and sex modulate metabolic and cardiovascular risk markers of patients after 1 year of highly active antiretroviral therapy (HAART). Atherosclerosis 187:177185.
49. Levy, J. A.,, M. G. Ory, and, S. Crystal. 2003. HIV/AIDS interventions for midlife and older adults: current status and challenges. J. Acquir. Immune Defic. Syndr. 33(Suppl. 2):S59S67.
50. Lichtenstein, K. A.,, C. Armon,, A. Baron,, A. C. Moorman,, K. C. Wood,, S. D. Holmberg,and the HIV Outpatient Study Investigators. 2005. Modification of the incidence of drug-associated symmetrical peripheral neuropathy by host and disease factors in the HIV outpatient study cohort. Clin. Infect. Dis. 40:148157.
51. Lima, V. D.,, R. S. Hogg,, P. R. Harrigan,, D. Moore,, B. Yip,, E. Wood, and, J. S. Montaner. 2007. Continued improvement in survival among HIV-infected individuals with newer forms of highly active antiretroviral therapy. AIDS 21:685692.
52. Liu, L.,, Y. Li,, L. J. Van Eldik,, W. S. Griffin, and, S. W. Barger. 2005. S100B-induced microglial and neuronal IL-1 expression is mediated by cell type-specific transcription factors. J. Neurochem. 92:546553.
53. Lopez, O. L.,, J. T. Becker,, M. A. Dew, and, R. Caldararo. 2004. Risk modifiers for peripheral sensory neuropathy in HIV infection/AIDS. Eur. J. Neurol. 11:97102.
54. Mack, K. A.,, and M. G. Ory. 2003. AIDS and older Americans at the end of the twentieth century. J. Acquir. Immune Defic. Syndr. 33(Suppl. 2):S168S175.
55. Maggi, P.,, G. Fiorentino,, G. Epifani,, N. Ladisa,, A. Lillo,, F. Perilli,, G. Impedovo,, S. Ferraro,, M. Gargiulo,, G. Angarano,, A. Chirianni, and, G. Pastore. 2002. Premature vascular lesions in HIV-positive patients: a clockwork bomb that will explode? AIDS 16:947948.
56. Maggi, P.,, G. Serio,, G. Epifani,, G. Fiorentino,, A. Saracino,, C. Fico,, F. Perilli,, A. Lillo,, S. Ferraro,, M. Gargiulo,, A. Chirianni,, G. Angarano,, G. Regina, and, G. Pastore. 2000. Premature lesions of the carotid vessels in HIV-1-infected patients treated with protease inhibitors. AIDS 14:F123F128.
57. Major, E. O.,, K. Amemiya,, C. Tornatore,, S. Houff, and, J. R. Berger. 1992. Pathogenesis and molecular biology of progressive multifocal leukoencephalopathy, the JC virus-induced demyelinating disease of the human brain. Clin. Microbiol. Rev. 5:4973.
58. Mayeux, R.,, Y. Stern,, M. X. Tang,, G. Todak,, K. Marder,, M. Sano,, M. Richards,, Z. Stein,, A. A. Ehrhardt, and, J. M. Gorman. 1993. Mortality risks in gay men with human immunodeficiency virus infection and cognitive impairment. Neurology 43:176182.
59. McArthur, J. C.,, D. R. Hoover,, H. Bacellar,, E. N. Miller,, B. A. Cohen,, J. T. Becker,, N. M. Graham,, J. H. McArthur,, O. A. Selnes,, L. P. Jacobson, et al. 1993. Dementia in AIDS patients: incidence and risk factors. Neurology 43:22452252.
60. Miami-Dade County Health Department. 2007. Monthly AIDS Surveillance Report, p. 1–11. Miami-Dade Health Dept., Miami, FL.
61. Mitchell, P. D.,, and T. N. Mitchell. 2000. The age-dependent deterioration in light touch sensation on the plantar aspect of the foot in a rural community in India: implications when screening for sensory impairment. Leprosy Rev. 71:169178.
62. Moore, D. J.,, E. Masliah,, J. D. Rippeth,, R. Gonzalez,, C. L. Carey,, M. Cherner,, R. J. Ellis,, C. L. Achim,, T. D. Marcotte,, R. K. Heaton,, I. Grant,and the HNRC Group. 2006. Cortical and subcortical neurodegeneration is associated with HIV neurocognitive impairment. AIDS 20:879887.
63. Morgello, S.,, L. Estanislao,, D. Simpson,, A. Geraci,, A. DiRocco,, P. Gerits,, E. Ryan,, T. Yakoushina,, S. Khan,, R. Mahboob,, M. Naseer,, D. Dorfman,, V. Sharp,and the Manhattan HIV Brain Bank. 2004. HIV-associated distal sensory polyneuropathy in the era of highly active antiretroviral therapy: the Manhattan HIV Brain Bank. Arch. Neurol. 61:546551.
64. Mori, M.,, N. Aoki,, H. Shimada,, M. Tajima, and, K. Kato. 1992. Detection of JC virus in the brains of aged patients without progressive multifocal leukoencephalopathy by the polymerase chain reaction and Southern hybridization analysis. Neurosci. Lett. 141:151155.
65. Munhoz, C. D.,, L. B. Lepsch,, E. M. Kawamoto,, M. B. Malta,, L. de Sá Lima,, M. C. Avellar,, J. K. Richardson, and, E. A. Hurvitz. 1995. Peripheral neuropathy: a true risk factor for falls. J. Gerontol. 50:M211M215.
66. Murasko, D. W.,, P. Weiner, and, D. Kaye. 1988. Association of lack of mitogen-induced lymphocyte proliferation with increased mortality in the elderly. Aging Immunol. Infect. Dis. 1:16.
67. Nogueras, M.,, G. Navarro,, E. Antón,, M. Sala,, M. Cervantes,, M. Mengual, and, F. Segura. 2006. Epidemiological and clinical features, response to HAART, and survival in HIV-infected patients diagnosed at the age of 50 or more. BMC Infect. Dis. 6:159.
68. Obrams, G. I.,, and S. Grufferman. 1991. Epidemiology of HIV associated non-Hodgkin lymphoma. Cancer Surv. 10:91102.
69. Olsson, J.,, A. Wikby,, B. Johansson,, S. Lofgren,, B. O. Nilsson, and, F. G. Ferguson. 2000. Age-related changes in peripheral blood T-lymphocyte subpopulations and cytomegalovirus infection in the very old: the Swedish longitudinal OCTO immune study. Mech. Ageing Dev. 121:187201.
70. Operskalski, E. A.,, J. W. Mosley,, M. P. Busch, and, D. O. Stram. 1997. Influences of age, viral load and CD4+ count on the rate of progression of HIV-1 infection to AIDS. J. AIDS. Hum. Retrovirol. 15:243244.
71. Pantanowitz, L.,, H. P. Schlecht, and, B. J. Dezube. 2006. The growing problem of non-AIDS-defining malignancies in HIV. Curr. Opin. Oncol. 18:469478.
72. Petito, C. K.,, B. Roberts,, J. D. Cantando,, A. Rabinstein, and, R. Duncan. 2001. Hippocampal injury and alterations in neuronal chemokine co-receptor expression in patients with AIDS. J. Neuropathol. Exp. Neurol. 60:377385.
73. Petito, C. K.,, and B. Roberts. 1995. Evidence of apoptotic cell death in HIV encephalitis. Am. J. Pathol. 146:11211130.
74. Petoumenos, K.,, M. G. Law,and the Australian HIV Observational Database. 2006. Risk factors and causes of death in the Australian HIV Observational Database. Sex. Health 3:103112.
75. Pitts, M.,, J. Grierson, and, S. Misson. 2005. Growing older with HIV: a study of health, social and economic circumstances for people living with HIV in Australia over the age of 50 years. AIDS Patient Care STDs 19:460465.
76. Poli, G.,, and A. S. Fauci. 1992. The effect of cytokines and pharmacologic agents on chronic HIV infection. AIDS Res. Hum. Retrovir. 8:191197.
77. Prado, J. G.,, N. T. Parkin,, B. Clotet,, L. Ruiz, and, J. Martinez-Picado. 2005. HIV type 1 fitness evolution in antiretroviral-experienced patients with sustained CD4+ T cell counts but persistent virologic failure. Clin. Infect. Dis 41:729737.
78. Rabkin, J. G.,, M. C. McElhiney, and, S. J. Ferrando. 2004. Mood and substance use disorders in older adults with HIV/AIDS: methodological issues and preliminary evidence. AIDS 18(Suppl. 1):S43S48.
79. Rempel, H. C.,, and L. Pulliam. 2005. HIV-1 Tat inhibits neprilysin and elevates amyloid beta. AIDS 19:127135.
80. Sa, M. J.,, M. D. Madeira,, C. Ruela,, B. Volk,, A. Mota-Miranda, and, M. M. Paula-Barbosa. 2004. Dendritic changes in the hippocampal formation of AIDS patients: a quantitative Golgi study. Acta Neuropathol. 107:97110.
81. Sa, M. J.,, M. D. Madeira,, C. Ruela,, B. Volk,, A. Mota-Miranda,, H. Lecour,, V. Goncalves, and, M. M. Paula-Barbosa. 2000. AIDS does not alter the total number of neurons in the hippocampal formation but induces cell atrophy: a stereological study. Acta Neuropathol. 99:643653.
82. Saah, A. J.,, D. R. Hoover,, Y. He,, L. A. Kingsley, and, J. P. Phair. 1994. Factors influencing survival after AIDS: report from the Multicenter AIDS Cohort Study (MACS). J. Acquir. Immune Defic. Syndr. 7:287295.
83. Sacco, R. L.,, R. Adams,, G. Albers,, M. J. Alberts,, O. Benavente,, K. Furie,, L. B. Goldstein,, P. Gorelick,, J. Halperin,, R. Harbaugh,, S. C. Johnston,, I. Katzan,, M. Kelly-Hayes,, E. J. Kenton,, M. Marks,, L. H. Schwamm,, T. Tomsick,American Heart Association, American Stroke Association Council on Stroke, Council on Cardiovascular Radiology and Intervention, and the American Academy of Neurology. 2006. AHA/ASA Guidelines. Guidelines for prevention of stroke in patients with ischemic stroke or transient ischemic attack. A statement for healthcare professionals from the American Heart Association/American Stroke Association Council on Stroke. Stroke 37:577617.
84. Sapolsky, R. M.,, and C. Scavone. 2006. Chronic unpredictable stress exacerbates lipopolysaccharide-induced activation of nuclear factor-κB in the frontal cortex and hippocampus via glucocorticoid secretion. J. Neurosci. 26:38133820.
85. Saule, P.,, J. Trauet,, V. Dutriez,, V. Lekeux,, J. P. Dessaint, and, M. Labalette. 2006. Accumulation of memory T cells from childhood to old age: central and effector memory cells in CD4+ versus effector memory and terminally differentiated memory cells in CD8+ compartment. Mech. Ageing Dev. 127:274281.
86. Shapshak, P.,, S. M. Segal,, K. A. Crandall,, R. K. Fujimura,, B.-T. Zhang,, K.-Q. Xin,, K. Okuda,, C. K. Petito,, C. Eisdorfer, and, K. Goodkin. 1999. Independent evolution of HIV type 1 in different brain regions. AIDS Res. Hum. Retrovir. 15:811820.
87. Sheline, Y. I.,, M. H. Gado, and, H. C. Kraemer. 2003. Untreated depression and hippocampal volume loss. Am. J. Psychiatry 160:15161518.
88. Shytle, R. D.,, D. Obregon,, J. Ehrhart,, F. Fernandez, and, J. Tan. 2006. Antiretrovirals increase neuronal production and disrupt microglial phagocytosis of β-amyloid. In CONGREX Sweden AB (ed.), Abstr. XVIth Int. Conf. AIDS, 13–18 August 2006, Toronto, Canada. International AIDS Society, Stockholm, Sweden.
89. Siegel, K.,, E. W. Schrimshaw, and, L. Dean. 1999. Symptom interpretation: implications for delay in HIV testing and care among HIV-infected late middle-aged and older adults. AIDS Care 11:525535.
90. Silverberg, M. J.,, W. Leyden,, M. A. Horberg,, G. N. DeLorenze,, D. Klein, and, C. P. Quesenberry, Jr. 2007. Older age and the response to and tolerability of antiretroviral therapy. Arch. Int. Med. 167:684691.
91. Simpson, D. M.,, D. A. Katzenstein,, M. D. Hughes,, S. M. Hammer,, D. L. Williamson,, Q. Jiang,, J. T. Pi, et al. 1998. Neuromuscular function in HIV infection: analysis of a placebo-controlled combination antiretroviral trial. AIDS 12:24252432.
92. Skiest, D. J.,, E. Rubinstein,, N. Carley,, L. Gioiella, and, R. Lyons. 1996. The importance of comorbidity in HIV-infected patients over 55. A retrospective case-control study. Am. J. Med. 101:605611.
93. Small, S. A.,, W. Y. Tsai,, R. DeLaPaz,, R. Mayeux, and, Y. Stern. 2002. Imaging hippocampal function across the human life span: is memory decline normal or not? Ann. Neurol. 51:290295.
94. Stout, J. C.,, D. P. Salmon,, N. Butters,, M. Taylor,, G. Peavy,, W. C. Heindel,, D. C. Delis,, L. Ryan,, J. H. Atkinson,, J. L. Chandler, and, I. Grant. 1995. Progressive cerebral volume loss in human immunodeficiency virus infection. Arch. Neurol. 55:161168.
95. Valcour, V.,, C. Shikuma,, B. Shiramizu,, M. Watters,, P. Poff,, O. Selnes,, P. Holck,, J. Grove, and, N. Sacktor. 2004a. Higher frequency of dementia in older HIV-1 individuals: the Hawaii Aging with HIV-1 Cohort. Neurology 63:822827.
96. Valcour, V.,, C. Shikuma,, B. Shiramizu,, M. Watters,, P. Poff,, O. A. Selnes,, J. Grove,, Y. Liu,, K. B. Abdul-Majid,, S. Gartner, and, N. Sacktor. 2004b. Age, apolipoprotein E4, and the risk of HIV dementia: the Hawaii Aging with HIV Cohort. J. Neuroimmunol. 157:197202.
97. van Gorp, W. G.,, E. N. Miller,, T. D. Marcotte,, W. Dixon,, D. Paz,, O. Selnes,, J. Wesch,, J. T. Becker,, C. H. Hinkin,, M. Mitrushina, et al. 1994. The relationship between age and cognitive impairment in HIV-1 infection: findings from Multicenter AIDS Cohort Study and clinical cohort. Neurology 44:929935.
98. Watters, M. R.,, P. W. Poff,, B. T. Shiramizu,, P. S. Holck,, K. M. Fast,, C. M. Shikuma, and, V. G. Valcour. 2004. Symptomatic distal sensory polyneuropathy in HIV after age 50. Neurology 62:13781383.
99. Welch, K.,, and A. Morse. 2002. Predictors of survival in older men with AIDS. Geriatric Nursing 23:6268.
100. Wiley, C. A.,, V. Soontornniyomkij,, L. Radhakrishnan,, E. Masliah,, J. Mellors,, S. A. Hermann,, P. Dailey, and, C. L. Achim. 1998. Distribution of brain HIV load in AIDS. Brain Pathol. 8:277284.
101. Wilkie, F. L.,, K. Goodkin,, I. Khamis,, M. H. van Zuilen,, D. Lee,, R. Lecusay,, M. Concha,, S. Symes,, P. Suarez, and, C. Eisdorfer. 2003. Cognitive functioning in younger and older HIV-1 infected adults. J. Acquir. Immune Defic. Syndr. 33(Suppl. 2):S93S105.
102. Wilkie, F. L.,, K. Goodkin,, R. Morgan,, D. Feaster,, M. A. Fletcher,, N. Blaney,, M. Baum,, J. Szapocznik, and, C. Eisdorfer. 1998. Mild cognitive impairment and risk of mortality in HIV-1 infection. J. Neurospsychiatry Clin. Neurosci. 10:125132.
103. Wilt, S. G.,, E. Milward,, J. M. Zhou,, K. Nagasato,, H. Patton,, R. Rusten,, D. E. Griffin,, M. O’Connor, and, M. Dubois-Dalcq. 1995. In vitro evidence for a dual role of tumor necrosis factor in human immunodeficiency virus type 1 encephalopathy. Ann. Neurol. 37:381394.
104. Wood, S.,, C. Hinkin,, S. Castellon, and, K. Yarema. 1998. Working memory deficits in HIV-1 infection. Brain Cognition 37:163166.
105. Wu, M. X.,, and S. F. Schlossman. 1997. Decreased ability of HIV-1 Tat protein-treated accessory cells to organize cellular clusters is associated with partial activation of T cells. Proc. Natl. Acad. Sci. USA 94:1383213837.
106. Zhang, J.,, and C. S. Crumpacker. 2001. Human immunodeficiency virus type 1 RNA in peripheral blood mononuclear cells of patients receiving prolonged highly active antiretroviral therapy. J. Infect. Dis. 184:13411344.
107. Zhou, L.,, D. W. Kitch,, S. R. Evans,, P. Hauer,, S. Raman,, G. J. Ebenezer,, M. Gerschenson,, C. M. Marra,, V. Valcour,, R. Diaz-Arrastia,, K. Goodkin,, L. Millar,, S. Shriver,, D. M. Asmuth,, D. B. Clifford,, D. M. Simpson,, J. C. McArthur,NARC and the ACTG A5117 Study Group. 2007. Correlates of epidermal nerve fiber densities in HIV-associated distal sensory polyneuropathy. Neurology 68:21132119.
108. Zingmond, D. S.,, N. S. Wenger,, S. Crystal,, G. F. Joyce,, H. Liu,, U. Sambamoorthi,, L. A. Lillard,, A. A. Leibowitz,, M. F. Shapiro, and, S. A. Bozzette. 2001. HCSUS Consortium. Circumstances at HIV diagnosis and progression of disease in older HIV-infected Americans. Am. J. Public Health 91:11171120.
109. Zingmond, D. S.,, A. M. Kilbourne,, A. C. Justice,, N. S. Wenger,, M. Rodriguez-Barradas,, L. Rabeneck,, D. Taub,, S. Weissman,, J. Briggs,, J. Wagner,, S. Smola, and, S. A. Bozzette. 2003. Differences in symptom expression in older HIV-positive patients: the Veterans Aging Cohort 3 Site Study and HIV Cost and Service Utilization Study experience. J. Acquir. Immune Defic. Syndr. 33(Suppl. 2):S84S92.

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