{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T05:26:44Z","timestamp":1790400404329,"version":"4.1.0"},"reference-count":106,"publisher":"Cambridge University Press (CUP)","issue":"4","license":[{"start":{"date-parts":[[2020,11,9]],"date-time":"2020-11-09T00:00:00Z","timestamp":1604880000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Int Neuropsychol Soc"],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S1355617720001022_as1\"><jats:title>Objectives:<\/jats:title><jats:p>Mounting evidence indicates that vascular risk factors (VRFs) are elevated in HIV and play a significant role in the development and persistence of HIV-associated neurocognitive disorder. Given the increased longevity of people living with HIV (PLWH), there is a great need to better elucidate vascular contributions to neurocognitive impairment in HIV. This systematic review and meta-analysis examine relationships between traditional VRFs, cardiovascular disease (CVD), and cognition in PLWH in the combination antiretroviral therapy era.<\/jats:p><\/jats:sec><jats:sec id=\"S1355617720001022_as2\"><jats:title>Methods:<\/jats:title><jats:p>For the systematic review, 44 studies met inclusion criteria and included data from 14,376 PLWH and 6,043 HIV-seronegative controls. To better quantify the contribution of VRFs to cognitive impairment in HIV, a robust variance estimation meta-analysis (<jats:italic>N<\/jats:italic> = 11 studies) was performed and included data from 2139 PLWH.<\/jats:p><\/jats:sec><jats:sec id=\"S1355617720001022_as3\"><jats:title>Results:<\/jats:title><jats:p>In the systematic review, cross-sectional and longitudinal studies supported relationships between VRFs, cognitive dysfunction, and decline, particularly in the domains of attention\/processing speed, executive functioning, and fine motor skills. The meta-analysis demonstrated VRFs were associated with increased odds of global neurocognitive impairment (odds ratio [OR ]= 2.059, <jats:italic>p<\/jats:italic> = .010), which remained significant after adjustment for clinical HIV variables (<jats:italic>p<\/jats:italic> = .017). Analyses of individual VRFs demonstrated type 2 diabetes (<jats:italic>p<\/jats:italic> = .004), hyperlipidemia (<jats:italic>p<\/jats:italic> = .043), current smoking (<jats:italic>p<\/jats:italic> = .037), and previous CVD (<jats:italic>p<\/jats:italic> = .0005) were significantly associated with global neurocognitive impairment.<\/jats:p><\/jats:sec><jats:sec id=\"S1355617720001022_as4\"><jats:title>Conclusions:<\/jats:title><jats:p>VRFs and CVD are associated with worse cognitive performance and decline, and neurocognitive impairment in PLWH. Future studies are needed to examine these relationships in older adults with HIV, and investigate how race\/ethnicity, gender, medical comorbidities, and psychosocial factors contribute to VRF-associated cognitive dysfunction in HIV.<\/jats:p><\/jats:sec>","DOI":"10.1017\/s1355617720001022","type":"journal-article","created":{"date-parts":[[2020,11,9]],"date-time":"2020-11-09T08:45:06Z","timestamp":1604911506000},"page":"365-381","source":"Crossref","is-referenced-by-count":39,"title":["HIV, Vascular Risk Factors, and Cognition in the Combination Antiretroviral Therapy Era: A Systematic Review and Meta-Analysis"],"prefix":"10.1017","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9614-5161","authenticated-orcid":false,"given":"Elissa C.","family":"McIntosh","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kayla","family":"Tureson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lindsay J.","family":"Rotblatt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elyse J.","family":"Singer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8414-7189","authenticated-orcid":false,"given":"April D.","family":"Thames","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2020,11,9]]},"reference":[{"key":"S1355617720001022_ref88","doi-asserted-by":"publisher","DOI":"10.1016\/j.neurobiolaging.2003.09.002"},{"key":"S1355617720001022_ref85","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2012.8488"},{"key":"S1355617720001022_ref107","doi-asserted-by":"publisher","DOI":"10.1111\/hiv.12238"},{"key":"S1355617720001022_ref57","doi-asserted-by":"publisher","DOI":"10.1017\/S1355617717000832"},{"key":"S1355617720001022_ref9","doi-asserted-by":"publisher","DOI":"10.3851\/IMP2925"},{"key":"S1355617720001022_ref13","doi-asserted-by":"publisher","DOI":"10.1007\/s13365-018-0706-5"},{"key":"S1355617720001022_ref61","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciw495"},{"key":"S1355617720001022_ref91","doi-asserted-by":"publisher","DOI":"10.1155\/2015\/641913"},{"key":"S1355617720001022_ref35","doi-asserted-by":"publisher","DOI":"10.1007\/s13365-013-0219-1"},{"key":"S1355617720001022_ref72","doi-asserted-by":"publisher","DOI":"10.1186\/s12968-014-0057-1"},{"key":"S1355617720001022_ref76","doi-asserted-by":"publisher","DOI":"10.1017\/S1355617719000018"},{"key":"S1355617720001022_ref80","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000001017"},{"key":"S1355617720001022_ref24","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-1293.2012.01044.x"},{"key":"S1355617720001022_ref55","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0b013e328333ea9e"},{"key":"S1355617720001022_ref42","doi-asserted-by":"publisher","DOI":"10.1002\/jrsm.5"},{"key":"S1355617720001022_ref33","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra041811"},{"key":"S1355617720001022_ref7","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkh013"},{"key":"S1355617720001022_ref82","doi-asserted-by":"publisher","DOI":"10.1177\/2040622312471840"},{"key":"S1355617720001022_ref50","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehr133"},{"key":"S1355617720001022_ref63","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0b013e31821ff8bd"},{"key":"S1355617720001022_ref54","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cis489"},{"key":"S1355617720001022_ref98","doi-asserted-by":"publisher","DOI":"10.1007\/s13365-015-0330-6"},{"key":"S1355617720001022_ref23","doi-asserted-by":"publisher","DOI":"10.1007\/s13365-018-0640-6"},{"key":"S1355617720001022_ref62","doi-asserted-by":"publisher","DOI":"10.1007\/s13365-012-0106-1"},{"key":"S1355617720001022_ref67","doi-asserted-by":"publisher","DOI":"10.1097\/COH.0b013e328347876c"},{"key":"S1355617720001022_ref32","doi-asserted-by":"publisher","DOI":"10.1016\/j.jinf.2012.07.005"},{"key":"S1355617720001022_ref86","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000001414"},{"key":"S1355617720001022_ref43","doi-asserted-by":"publisher","DOI":"10.1002\/9781119536604"},{"key":"S1355617720001022_ref71","doi-asserted-by":"publisher","DOI":"10.1037\/0735-7044.117.6.1169"},{"key":"S1355617720001022_ref25","unstructured":"Fisher, Z. , Tipton, E. , & Zhipeng, H. (2017). Robumeta: Robust variance meta-regression (Version 2.0) [R package]. Retrieved from https:\/\/CRAN.R-project.org\/package=robumeta"},{"key":"S1355617720001022_ref81","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.110.583856"},{"key":"S1355617720001022_ref69","doi-asserted-by":"publisher","DOI":"10.1080\/13803395.2013.783000"},{"key":"S1355617720001022_ref87","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000001133"},{"key":"S1355617720001022_ref108","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e3181f11bd8"},{"key":"S1355617720001022_ref51","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000007125"},{"key":"S1355617720001022_ref94","doi-asserted-by":"publisher","DOI":"10.1007\/s11904-013-0168-6"},{"key":"S1355617720001022_ref104","doi-asserted-by":"publisher","DOI":"10.1007\/s13365-016-0509-5"},{"key":"S1355617720001022_ref65","doi-asserted-by":"publisher","DOI":"10.1080\/13548506.2016.1199887"},{"key":"S1355617720001022_ref79","doi-asserted-by":"publisher","DOI":"10.1097\/00126334-199305000-00011"},{"key":"S1355617720001022_ref114","unstructured":"Centers for Disease Control and Prevention. (2020, May). HIV Surveillance Report 2018 (Updated); vol. 31. Retrieved from http:\/\/www.cdc.gov\/hiv\/library\/reports\/hiv-surveillance.html"},{"key":"S1355617720001022_ref47","first-page":"1","article-title":"Managing dyslipidemia in HIV\/AIDS patients: Challenges and solutions","volume":"7","author":"Husain","year":"2015","journal-title":"HIV\/AIDS (Auckland, NZ)"},{"key":"S1355617720001022_ref96","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e318236ef23"},{"key":"S1355617720001022_ref16","doi-asserted-by":"publisher","DOI":"10.1089\/aid.2017.0008"},{"key":"S1355617720001022_ref83","doi-asserted-by":"publisher","DOI":"10.1111\/hiv.12233"},{"key":"S1355617720001022_ref14","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2018.03.137"},{"key":"S1355617720001022_ref44","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.327.7414.557"},{"key":"S1355617720001022_ref66","doi-asserted-by":"publisher","DOI":"10.1310\/hct1102-100"},{"key":"S1355617720001022_ref17","doi-asserted-by":"publisher","DOI":"10.1007\/s11481-017-9748-3"},{"key":"S1355617720001022_ref30","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0132321"},{"key":"S1355617720001022_ref49","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0000000000001906"},{"key":"S1355617720001022_ref113","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0000000000001466"},{"key":"S1355617720001022_ref68","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(10)70104-6"},{"key":"S1355617720001022_ref10","doi-asserted-by":"publisher","DOI":"10.1089\/apc.2008.0082"},{"key":"S1355617720001022_ref26","doi-asserted-by":"publisher","DOI":"10.1001\/archneurol.2008.582"},{"key":"S1355617720001022_ref106","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.114.001035"},{"key":"S1355617720001022_ref19","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2011.09.019"},{"key":"S1355617720001022_ref18","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000001815"},{"key":"S1355617720001022_ref90","volume-title":"R: A Language and Environment for Statistical Computing","year":"2014"},{"key":"S1355617720001022_ref12","doi-asserted-by":"publisher","DOI":"10.1353\/hpu.2005.0093"},{"key":"S1355617720001022_ref11","doi-asserted-by":"publisher","DOI":"10.1007\/s13365-011-0052-3"},{"key":"S1355617720001022_ref99","doi-asserted-by":"publisher","DOI":"10.1097\/01.qai.0000243119.67529.f5"},{"key":"S1355617720001022_ref84","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000000262"},{"key":"S1355617720001022_ref89","doi-asserted-by":"publisher","DOI":"10.1007\/s40865-016-0026-5"},{"key":"S1355617720001022_ref56","doi-asserted-by":"publisher","DOI":"10.1097\/COH.0000000000000227"},{"key":"S1355617720001022_ref60","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0000000000001230"},{"key":"S1355617720001022_ref53","doi-asserted-by":"publisher","DOI":"10.3851\/IMP2952"},{"key":"S1355617720001022_ref75","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000007779"},{"key":"S1355617720001022_ref6","doi-asserted-by":"publisher","DOI":"10.1002\/jrsm.12"},{"key":"S1355617720001022_ref3","doi-asserted-by":"publisher","DOI":"10.1007\/s00234-011-0854-2"},{"key":"S1355617720001022_ref112","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0000000000001964"},{"key":"S1355617720001022_ref78","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0000000000000458"},{"key":"S1355617720001022_ref102","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbadis.2008.09.004"},{"key":"S1355617720001022_ref77","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000002193"},{"key":"S1355617720001022_ref58","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e3182478d64"},{"key":"S1355617720001022_ref101","doi-asserted-by":"publisher","DOI":"10.1016\/j.ynstr.2016.02.005"},{"key":"S1355617720001022_ref100","doi-asserted-by":"publisher","DOI":"10.1097\/00126334-200501010-00006"},{"key":"S1355617720001022_ref40","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e318200d727"},{"key":"S1355617720001022_ref20","doi-asserted-by":"publisher","DOI":"10.3233\/JAD-2010-091552"},{"key":"S1355617720001022_ref15","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2007.12.024"},{"key":"S1355617720001022_ref38","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/civ325"},{"key":"S1355617720001022_ref34","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejphar.2008.01.052"},{"key":"S1355617720001022_ref48","doi-asserted-by":"publisher","DOI":"10.3233\/JAD-141812"},{"key":"S1355617720001022_ref103","doi-asserted-by":"publisher","DOI":"10.18637\/jss.v036.i03"},{"key":"S1355617720001022_ref2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e3181bd10e7"},{"key":"S1355617720001022_ref105","unstructured":"Wilson, D.B. (n.d.). Practical meta-analysis effect size calculator [Online calculator]. Retrieved from https:\/\/campbellcollaboration.org\/research-resources\/effect-size-calculator.html"},{"key":"S1355617720001022_ref8","first-page":"274","article-title":"Cognitive impairment and cardiovascular disease related to alexithymia in a well-controlled HIV-infected population","volume":"27","author":"Ciccarelli","year":"2019","journal-title":"Le Infezioni in Medicina"},{"key":"S1355617720001022_ref52","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.322.7300.1447"},{"key":"S1355617720001022_ref59","doi-asserted-by":"publisher","DOI":"10.2337\/dc18-1399"},{"key":"S1355617720001022_ref41","doi-asserted-by":"publisher","DOI":"10.1017\/S1355617704102130"},{"key":"S1355617720001022_ref95","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2006-2190"},{"key":"S1355617720001022_ref64","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000001109"},{"key":"S1355617720001022_ref46","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0000000000001685"},{"key":"S1355617720001022_ref21","first-page":"89","article-title":"A nonparametric \u201ctrim and fill\u201d method of accounting for publication bias in meta-analysis","volume":"95","author":"Duval","year":"2000","journal-title":"Journal of the American Statistical Association"},{"key":"S1355617720001022_ref70","doi-asserted-by":"publisher","DOI":"10.1089\/aid.2018.0279"},{"key":"S1355617720001022_ref45","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0b013e32832b514b"},{"key":"S1355617720001022_ref93","doi-asserted-by":"publisher","DOI":"10.1080\/13803395.2012.747596"},{"key":"S1355617720001022_ref4","doi-asserted-by":"publisher","DOI":"10.2307\/2533446"},{"key":"S1355617720001022_ref97","doi-asserted-by":"publisher","DOI":"10.1089\/aid.2011.0159"},{"key":"S1355617720001022_ref109","doi-asserted-by":"publisher","DOI":"10.1159\/000093576"},{"key":"S1355617720001022_ref31","doi-asserted-by":"publisher","DOI":"10.1037\/neu0000366"},{"key":"S1355617720001022_ref27","doi-asserted-by":"publisher","DOI":"10.1080\/13854040903482830"},{"key":"S1355617720001022_ref110","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000001842"},{"key":"S1355617720001022_ref111","doi-asserted-by":"publisher","DOI":"10.1016\/j.pnpbp.2007.08.018"},{"key":"S1355617720001022_ref22","doi-asserted-by":"publisher","DOI":"10.1111\/j.0006-341X.2000.00455.x"},{"key":"S1355617720001022_ref73","doi-asserted-by":"publisher","DOI":"10.1037\/0033-2909.86.3.638"},{"key":"S1355617720001022_ref39","doi-asserted-by":"publisher","DOI":"10.7448\/IAS.17.4.19516"}],"container-title":["Journal of the International Neuropsychological Society"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S1355617720001022","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,4,5]],"date-time":"2021-04-05T10:52:44Z","timestamp":1617619964000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S1355617720001022\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,11,9]]},"references-count":106,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2021,4]]}},"alternative-id":["S1355617720001022"],"URL":"https:\/\/doi.org\/10.1017\/s1355617720001022","relation":{},"ISSN":["1355-6177","1469-7661"],"issn-type":[{"value":"1355-6177","type":"print"},{"value":"1469-7661","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,11,9]]}}}