{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T01:01:02Z","timestamp":1792803662700,"version":"4.5.0"},"reference-count":59,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2022,12,7]],"date-time":"2022-12-07T00:00:00Z","timestamp":1670371200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100000025","name":"National Institute of Mental Health","doi-asserted-by":"publisher","award":["R01 MH107345"],"award-info":[{"award-number":["R01 MH107345"]}],"id":[{"id":"10.13039\/100000025","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000025","name":"National Institute of Mental Health","doi-asserted-by":"publisher","award":["P30 MH062512"],"award-info":[{"award-number":["P30 MH062512"]}],"id":[{"id":"10.13039\/100000025","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"NIH","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,3,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Modern antiretroviral therapy (ART) has increased longevity of people with HIV and shifted the age distribution of the HIV pandemic upward toward that of the general population. This positive development has also led to concerns about premature and\/or accelerated neurocognitive and physical ageing due to the combined effects of chronic HIV, accumulating comorbidities, adverse effects or possible toxicities of ART and biological ageing. Here we present results of comprehensive assessments over 12 years of 402 people with HIV in the CNS HIV ART Effects Research (CHARTER) programme, who at follow-up were composed of younger (&amp;lt;60 years) and older (\u226560 years) subgroups.<\/jats:p>\n                  <jats:p>Over the 12 years, ART use and viral suppression increased in both subgroups as did systemic and psychiatric comorbidities; participants in both subgroups also evidenced neurocognitive decline beyond what is expected in typical ageing. Contrary to expectations, all these adverse effects were comparable in the younger and older CHARTER subgroups, and unrelated to chronological age. Neurocognitive decline was unrelated to HIV disease or treatment characteristics but was significantly predicted by the presence of comorbid conditions, specifically diabetes, hypertension, chronic pulmonary disease, frailty, neuropathic pain, depression and lifetime history of cannabis use disorder. These results are not consistent with premature or accelerated neurocognitive ageing due to HIV itself but suggest important indirect effects of multiple, potentially treatable comorbidities that are more common among people with HIV than in the general population.<\/jats:p>\n                  <jats:p>Good medical management of HIV disease did not prevent these adverse outcomes, and increased attention to a range of comorbid conditions in people with HIV may be warranted in their care.<\/jats:p>","DOI":"10.1093\/brain\/awac465","type":"journal-article","created":{"date-parts":[[2022,12,7]],"date-time":"2022-12-07T02:59:24Z","timestamp":1670381964000},"page":"1121-1131","source":"Crossref","is-referenced-by-count":56,"title":["Twelve-year neurocognitive decline in HIV is associated with comorbidities, not age: a CHARTER study"],"prefix":"10.1093","volume":"146","author":[{"given":"Robert K","family":"Heaton","sequence":"first","affiliation":[{"name":"Department of Psychiatry, University of California San Diego , San Diego, CA 92093 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4931-752X","authenticated-orcid":false,"given":"Ronald J","family":"Ellis","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, University of California San Diego , San Diego, CA 92093 , USA"},{"name":"Department of Neurosciences, University of California , San Diego, CA 92093 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bin","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, University of California San Diego , San Diego, CA 92093 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina M","family":"Marra","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Washington , Seattle, WA 98104 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leah H","family":"Rubin","sequence":"additional","affiliation":[{"name":"Department of Neurology, Johns Hopkins University , Baltimore, MD 21218 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David B","family":"Clifford","sequence":"additional","affiliation":[{"name":"Department of Neurology, Washington University at St. Louis , St. Louis, MO 63110 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J Allen","family":"McCutchan","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of California San Diego , San Diego, CA 92093 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin B","family":"Gelman","sequence":"additional","affiliation":[{"name":"Department of Pathology, University of Texas Medical Branch , Galveston, TX 77555 , USA"},{"name":"Department of Neuroscience and Cell Biology, University of Texas Medical Branch , Galveston, TX 77555 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Morgello","sequence":"additional","affiliation":[{"name":"Department of Neurology, Icahn School of Medicine at Mount Sinai , New York, NY 10029 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donald R","family":"Franklin","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, University of California San Diego , San Diego, CA 92093 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3490-4975","authenticated-orcid":false,"given":"Scott L","family":"Letendre","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, University of California San Diego , San Diego, CA 92093 , USA"},{"name":"Department of Medicine, University of California San Diego , San Diego, CA 92093 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,12,7]]},"reference":[{"key":"2023053118590689500_awac465-B1","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1007\/s13365-010-0006-1","article-title":"HIV-associated neurocognitive disorders before and during the era of combination antiretroviral therapy: Differences in rates, nature, and predictors","volume":"17","author":"Heaton","year":"2011","journal-title":"J Neurovirol"},{"key":"2023053118590689500_awac465-B2","doi-asserted-by":"crossref","first-page":"1243","DOI":"10.1097\/QAD.0b013e3283354a7b","article-title":"Cognitive dysfunction in HIV patients despite long-standing suppression of viremia","volume":"24","author":"Simioni","year":"2010","journal-title":"AIDS"},{"key":"2023053118590689500_awac465-B3","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1097\/QAI.0b013e318042e1ee","article-title":"Persistence of neuropsychologic deficits despite long-term highly active antiretroviral therapy in patients with HIV-related neurocognitive impairment: Prevalence and risk factors. 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