{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T01:43:05Z","timestamp":1760060585899,"version":"build-2065373602"},"reference-count":68,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2025,9,10]],"date-time":"2025-09-10T00:00:00Z","timestamp":1757462400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Aga Khan University Research Council","award":["#212021","111024CRP2013","040225FD4710"],"award-info":[{"award-number":["#212021","111024CRP2013","040225FD4710"]}]},{"name":"Nazarbayev University Collaborative Research Program (CRP)","award":["#212021","111024CRP2013","040225FD4710"],"award-info":[{"award-number":["#212021","111024CRP2013","040225FD4710"]}]},{"name":"Faculty Development Collaborative Research Program (FDCRGP)","award":["#212021","111024CRP2013","040225FD4710"],"award-info":[{"award-number":["#212021","111024CRP2013","040225FD4710"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Viruses"],"abstract":"<jats:p>Background: In people living with HIV (PLHIV), ongoing neuronal injury has shown a correlation with elevated levels of soluble markers of immune activation, such as sCD163. Additionally, various risk factors, such as injection drug use (IDU), can independently affect immune and cognitive functions, leading to neurocognitive impairment (NCI). However, the potential sCD163-IDU-NCI axis in ART-experienced PLHIV is not clear. This study aims to determine NCI prevalence and investigate the interplay between risk factors and sCD163 in Pakistani PLHIV. Methods: For this cross-sectional study, 150 PLHIV and 30 HIV-negative people who inject drugs (PWID) were recruited using a convenience sampling strategy. NCI screening was performed using the International HIV Dementia Scale (IHDS) tool. Blood samples from PLHIV were used to perform HIV recency testing using the Asante Rapid Recency Assay, and to evaluate sCD163 levels using ELISA. Sociodemographic and clinical data were collected from medical records. Subsequently, descriptive statistics were used to summarize data variables, while comparisons (two and multiple groups) between participants with and without NCI were conducted, respectively, using the Mann\u2013Whitney test or Kruskal\u2013Wallis test for continuous variables, and Fisher\u2019s exact test for categorial variables. Receiver Operating Characteristic (ROC) curve analysis was performed to assess the discriminative ability of sCD163. Logistic regression was used to identify predictors of neurocognitive impairment. Results: The majority of PLHIV had IDU as a high-risk behavior. In PLHIV, the median age was 34.5 years (IQR: 30\u201341), ART duration was 35 months (IQR: 17\u201354), and median CD4 count was 326.5 cells\/\u00b5L (IQR: 116\u2013545.5). Long-term infections (&gt;6 months post-seroconversion; median ART duration: 35 months; median CD4 counts: 326.5 cells\/\u03bcL) were noted in 83.3% of PLHIV. IHDS-based screening showed that 83.33% (all PLHIV) and 50% (PLHIV with no IDU history) scored \u2264 9 on the IHDS, suggestive of NCI. IHDS-component analysis showed the memory recall to be significantly affected in PLHIV compared to controls (median score 3.2 versus 3.7, respectively, p &lt; 0.001). Regression analysis showed only long-term infection (OR: 2.99, p = 0.03) to be significantly associated with neurocognitive impairment. sCD163 levels were significantly lower in PLHIV with NCI (mean = 7.48 ng\/mL, SD = 7.05) compared to those without NCI (mean = 14.82 ng\/mL, SD = 8.23; p &lt; 0.0001), with an AUC of 0.803 (95% CI: 0.72\u20130.88). However, after adjusting for IDU history, the regression analysis showed an odds ratio for sCD163 of 0.998 (95% CI: 0.934, 1.067, p = 0.957), indicating no association between sCD163 levels and NCI. Conclusion: This study reports a high prevalence of NCI in Pakistani PLHIV, and no association between sCD163 and neurocognitive impairment in PLHIV after adjustment for a history of IDU. Long-term infection and IDU were significantly linked to NCI, while only IDU was associated with lower sCD163 levels, regardless of NCI.<\/jats:p>","DOI":"10.3390\/v17091232","type":"journal-article","created":{"date-parts":[[2025,9,10]],"date-time":"2025-09-10T08:43:54Z","timestamp":1757493834000},"page":"1232","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Neurocognitive Impairment in ART-Experienced People Living with HIV: An Analysis of Clinical Risk Factors, Injection Drug Use, and the sCD163"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9344-5401","authenticated-orcid":false,"given":"Syed Zaryab","family":"Ahmed","sequence":"first","affiliation":[{"name":"Department of Biochemistry, Ziauddin University, Karachi 75000, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3517-1200","authenticated-orcid":false,"given":"Faiq","family":"Amin","sequence":"additional","affiliation":[{"name":"Department of Biological and Biomedical Sciences, Aga Khan University, Karachi 74800, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nida","family":"Farooqui","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences, Nazarbayev University School of Medicine, Astana 010000, Kazakhstan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-9207-0693","authenticated-orcid":false,"given":"Zhannur","family":"Omarova","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences, Nazarbayev University School of Medicine, Astana 010000, Kazakhstan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3390-7659","authenticated-orcid":false,"given":"Syed Faisal","family":"Mahmood","sequence":"additional","affiliation":[{"name":"Department of Medicine, Aga Khan University, Karachi 74800, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qurat ul ain","family":"Khan","sequence":"additional","affiliation":[{"name":"Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, MA 02115, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haider A.","family":"Naqvi","sequence":"additional","affiliation":[{"name":"South City Hospital, Karachi 75400, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aida","family":"Mumtaz","sequence":"additional","affiliation":[{"name":"Medical College, Aga Khan University, Karachi 74800, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saeeda","family":"Baig","sequence":"additional","affiliation":[{"name":"Department of Biochemistry, Ziauddin University, Karachi 75000, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Muhammad Rehan","family":"Khan","sequence":"additional","affiliation":[{"name":"Bridge Consultants Foundation, Karachi 74500, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sharaf A.","family":"Shah","sequence":"additional","affiliation":[{"name":"Bridge Consultants Foundation, Karachi 74500, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ali","family":"Hassan","sequence":"additional","affiliation":[{"name":"Neurology Department, Ziauddin University, Karachi 75000, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Srinivasa","family":"Bolla","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences, Nazarbayev University School of Medicine, Astana 010000, Kazakhstan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3442-8991","authenticated-orcid":false,"given":"Shamim","family":"Mushtaq","sequence":"additional","affiliation":[{"name":"Department of Biochemistry, Ziauddin University, Karachi 75000, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9497-0902","authenticated-orcid":false,"given":"Syed Hani","family":"Abidi","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences, Nazarbayev University School of Medicine, Astana 010000, Kazakhstan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,9,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"10209","DOI":"10.1128\/JVI.00872-07","article-title":"Human immunodeficiency virus type 1 subtype distribution in the worldwide epidemic: Pathogenetic and therapeutic implications","volume":"81","author":"Buonaguro","year":"2007","journal-title":"J. Virol."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Miedema, F., Hazenberg, M.D., Tesselaar, K., van Baarle, D., de Boer, R.J., and Borghans, J.A.M. (2013). Immune activation and collateral damage in AIDS pathogenesis. Front. Immunol., 4.","DOI":"10.3389\/fimmu.2013.00298"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1789","DOI":"10.1212\/01.WNL.0000287431.88658.8b","article-title":"Updated research nosology for HIV-associated neurocognitive disorders","volume":"69","author":"Antinori","year":"2007","journal-title":"Neurology"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1097\/COH.0000000000000035","article-title":"Drug use as a driver of HIV risks: Re-emerging and emerging issues","volume":"9","author":"Shaw","year":"2014","journal-title":"Curr. Opin. HIV AIDS"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1186\/1742-6405-11-13","article-title":"Viral and cellular factors underlying neuropathogenesis in HIV associated neurocognitive disorders (HAND)","volume":"11","author":"Rao","year":"2014","journal-title":"AIDS Res. Ther."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Zenebe, Y., Necho, M., Yimam, W., and Akele, B. (2022). Worldwide Occurrence of HIV-Associated Neurocognitive Disorders and Its Associated Factors: A Systematic Review and Meta-Analysis. Front. Psychiatry, 13.","DOI":"10.3389\/fpsyt.2022.814362"},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Debalkie Animut, M., Sorrie, M.B., Birhanu, Y.W., Teshale, M.Y., and Cysique, L.A. (2019). High prevalence of neurocognitive disorders observed among adult people living with HIV\/AIDS in Southern Ethiopia: A cross-sectional study. PLoS ONE, 14.","DOI":"10.1371\/journal.pone.0204636"},{"key":"ref_8","first-page":"8306823","article-title":"Prevalence of Cognitive Impairment and Its Predictors among HIV\/AIDS Patients on Antiretroviral Therapy in Jimma University Medical Center, Southwest Ethiopia","volume":"2019","year":"2019","journal-title":"Psychiatry J."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"146426","DOI":"10.1016\/j.brainres.2019.146426","article-title":"The impact of substance abuse on HIV-mediated neuropathogenesis in the current ART era","volume":"1724","author":"Chilunda","year":"2019","journal-title":"Brain Res."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"e000627","DOI":"10.1136\/bmjph-2023-000627","article-title":"Incidence and contributing factors of dementia among people living with HIV in British Columbia, Canada, from 2002 to 2016: A retrospective cohort study","volume":"2","author":"Honer","year":"2024","journal-title":"BMJ Public Health"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1080\/02791072.2020.1850946","article-title":"Cognitive Impairment among People Who Use Heroin and Fentanyl: Findings from the Miami Adult Studies on HIV (MASH) Cohort","volume":"53","author":"Tamargo","year":"2020","journal-title":"J. Psychoact. Drugs"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1016\/j.drugalcdep.2013.09.027","article-title":"Working memory and affective decision-making in addiction: A neurocognitive comparison between heroin addicts, pathological gamblers and healthy controls","volume":"134","author":"Yan","year":"2014","journal-title":"Drug Alcohol Depend."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"104689","DOI":"10.1016\/j.psyneuen.2020.104689","article-title":"Peripheral immune dysregulation in the ART era of HIV-associated neurocognitive impairments: A systematic review","volume":"118","author":"Williams","year":"2020","journal-title":"Psychoneuroendocrinology"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1387","DOI":"10.1097\/QAD.0b013e32836010bd","article-title":"Elevated sCD163 in plasma but not cerebrospinal fluid is a marker of neurocognitive impairment in HIV infection","volume":"27","author":"Burdo","year":"2013","journal-title":"AIDS"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1093\/infdis\/jiw506","article-title":"Monocyte Activation Is Associated With Worse Cognitive Performance in HIV-Infected Women With Virologic Suppression","volume":"215","author":"Imp","year":"2017","journal-title":"J. Infect. Dis."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"973","DOI":"10.1097\/QAD.0000000000001425","article-title":"Plasma soluble CD163 is associated with postmortem brain pathology in human immunodeficiency virus infection","volume":"31","author":"Bryant","year":"2017","journal-title":"AIDS"},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"de Oliveira, M.F., Murrell, B., P\u00e9rez-Santiago, J., Vargas, M., Ellis, R.J., Letendre, S., Grant, I., Smith, D.M., Woods, S.P., and Gianella, S. (2015). Circulating HIV DNA Correlates With Neurocognitive Impairment in Older HIV-infected Adults on Suppressive ART. Sci. Rep., 5.","DOI":"10.1038\/srep17094"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"665","DOI":"10.3892\/etm.2012.665","article-title":"Diagnostic accuracy of the International HIV Dementia Scale and HIV Dementia Scale: A meta-analysis","volume":"4","author":"Hu","year":"2012","journal-title":"Exp. Ther. Med."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"278","DOI":"10.1097\/QAI.0000000000002257","article-title":"Utility of the International HIV Dementia Scale for HIV-Associated Neurocognitive Disorder","volume":"83","author":"Molinaro","year":"2020","journal-title":"J. Acquir. Immune Defic. Syndr."},{"key":"ref_20","first-page":"e61972","article-title":"Evaluation of the Training Program to Train HIV Treatment Center Staff in Pakistan","volume":"16","author":"Shah","year":"2024","journal-title":"Cureus"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Abidi, S.H., Nduva, G.M., Siddiqui, D., Rafaqat, W., Mahmood, S.F., Siddiqui, A.R., Nathwani, A.A., Hotwani, A., Shah, S.A., and Memon, S. (2021). Phylogenetic and Drug-Resistance Analysis of HIV-1 Sequences From an Extensive Paediatric HIV-1 Outbreak in Larkana, Pakistan. Front. Microbiol., 12.","DOI":"10.3389\/fmicb.2021.658186"},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Siddiqui, D., Badar, U., Javaid, M., Farooqui, N., Shah, S.A., Iftikhar, A., Sultan, F., Mir, F., Furqan, S., and Mahmood, S.F. (2023). Genetic and antiretroviral drug resistance mutations analysis of reverse transcriptase and protease gene from Pakistani people living with HIV-1. PLoS ONE, 18.","DOI":"10.1371\/journal.pone.0290425"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Tariq, U., Nazziwa, J., Sasinovich, S., Shah, S.A., Naeem, S., Abidi, S.H., and Esbj\u00f6rnsson, J. (2022). Phylogenetic Characterization of HIV-1 Sub-Subtype A1 in Karachi, Pakistan. Viruses, 14.","DOI":"10.3390\/v14102307"},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Rashid, A., Kang, L., Yi, F., Chu, Q., Shah, S.A., Mahmood, S.F., Getaneh, Y., Wei, M., Chang, S., and Abidi, S.H. (2024). Human Immunodeficiency Virus Type-1 Genetic Diversity and Drugs Resistance Mutations among People Living with HIV in Karachi, Pakistan. Viruses, 16.","DOI":"10.3390\/v16060962"},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Dang, C.M., Nelson, C.M., Feaster, D.J., Kizhner, A., Forrest, D.W., Nakamura, N., Iyer, A., Ghanta, P.P., Jayaweera, D.T., and Rodriguez, A.E. (2023). Opioids exacerbate inflammation in people with well-controlled HIV. Front. Immunol., 14.","DOI":"10.3389\/fimmu.2023.1277491"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"519","DOI":"10.1097\/QAI.0000000000002893","article-title":"Impact of Heroin and HIV on Gut Integrity and Immune Activation","volume":"89","author":"Hileman","year":"2022","journal-title":"J. Acquir. Immune Defic. Syndr."},{"key":"ref_27","unstructured":"Grebe, E., Facente, S., Hampton, D., Cheng, C., Owen, R., and Keating, S. (2019). Asant\u00e9\u2122 HIV-1 Rapid Recency\u00ae Assay Evaluation Report, Version 1.0, Zenodo."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"e34410","DOI":"10.2196\/34410","article-title":"Use of HIV Recency Assays for HIV Incidence Estimation and Other Surveillance Use Cases: Systematic Review","volume":"8","author":"Facente","year":"2022","journal-title":"JMIR Public Health Surveill."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Yufenyuy, E.L., Detorio, M., Dobbs, T., Patel, H.K., Jackson, K., Vedapuri, S., Parekh, B.S., and Shin, S. (2022). Performance evaluation of the Asante Rapid Recency Assay for verification of HIV diagnosis and detection of recent HIV-1 infections: Implications for epidemic control. PLoS Glob. Public Health, 2.","DOI":"10.1371\/journal.pgph.0000316"},{"key":"ref_30","first-page":"1367","article-title":"The International HIV Dementia Scale: A new rapid screening test for HIV dementia","volume":"19","author":"Sacktor","year":"2005","journal-title":"AIDS Behav."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1621","DOI":"10.1007\/s10461-016-1316-y","article-title":"A Comparison of Five Brief Screening Tools for HIV-Associated Neurocognitive Disorders in the USA and South Africa","volume":"20","author":"Joska","year":"2016","journal-title":"AIDS Behav."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"695","DOI":"10.1111\/j.1532-5415.2005.53221.x","article-title":"The Montreal Cognitive Assessment, MoCA: A brief screening tool for mild cognitive impairment","volume":"53","author":"Nasreddine","year":"2005","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1867","DOI":"10.1097\/QAD.0b013e32833adbcf","article-title":"Long-term increase in CD4+ T-cell counts during combination antiretroviral therapy for HIV-1 infection","volume":"24","author":"Lok","year":"2010","journal-title":"AIDS"},{"key":"ref_34","first-page":"10","article-title":"International HIV Dementia Scale: Screening for HIV-Associated Neurocognitive Disorders in Oc-cupational Settings","volume":"21","author":"Meintjes","year":"2015","journal-title":"Occup. Health South. Afr. (Online)"},{"key":"ref_35","first-page":"35","article-title":"Cognitive impairment in patients with AIDS\u2013prevalence and severity","volume":"7","author":"Watkins","year":"2015","journal-title":"HIV AIDS"},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Marin-Webb, V., Jessen, H., Kopp, U., Jessen, A.B., and Hahn, K. (2016). Validation of the International HIV Dementia Scale as a Screening Tool for HIV-Associated Neurocognitive Disorders in a German-Speaking HIV Outpatient Clinic. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0168225"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1016\/j.ijid.2020.09.755","article-title":"Neurological manifestations of HIV\/AIDS to tertiary care hospital in KP, Peshawar, Pakistan","volume":"101","author":"Khan","year":"2020","journal-title":"Int. J. Infect. Dis."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"118","DOI":"10.52206\/jsmc.2022.12.3.637","article-title":"Frequency of Common Neurological Manifestations among Patients Presenting with Human Immunodeficiency Virus Positivity","volume":"12","author":"Asad","year":"2022","journal-title":"J. Saidu Med. Coll."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1213","DOI":"10.1007\/s10461-010-9684-1","article-title":"Neurocognitive impairment and HIV risk factors: A reciprocal relationship","volume":"14","author":"Anand","year":"2010","journal-title":"AIDS Behav."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1007\/s40429-014-0028-5","article-title":"HIV-related neurocognitive disorders and drugs of abuse: Mired in confound, surrounded by risk","volume":"1","author":"Kennedy","year":"2014","journal-title":"Curr. Addict. Rep."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1111\/j.1749-6632.2009.05277.x","article-title":"Human immunodeficiency virus-associated neurocognitive disorder: Pathophysiology in relation to drug addiction","volume":"1187","author":"Nath","year":"2010","journal-title":"Ann. N. Y. Acad. Sci."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"88","DOI":"10.52206\/jsmc.2020.10.1.289","article-title":"Pattern of Drugs Misuse among Patients attending Iftikhar Psychiatric Hospital, Peshawar","volume":"10","author":"Khan","year":"2020","journal-title":"J. Saidu Med. Coll."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1186\/s40545-019-0199-5","article-title":"The association of HIV and easy access to narcotics in Pakistan; calling drug policy makers","volume":"12","author":"Mallhi","year":"2019","journal-title":"J. Pharm. Policy Pract."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1080\/13803395.2017.1349879","article-title":"HIV-associated executive dysfunction in the era of modern antiretroviral therapy: A systematic review and meta-analysis","volume":"40","author":"Walker","year":"2018","journal-title":"J. Clin. Exp. Neuropsychol."},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Wilson, T.W., Proskovec, A.L., Heinrichs-Graham, E., O\u2019nEill, J., Robertson, K.R., Fox, H.S., and Swindells, S. (2017). Aberrant Neuronal Dynamics during Working Memory Operations in the Aging HIV-Infected Brain. Sci. Rep., 7.","DOI":"10.1038\/srep41568"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"100189","DOI":"10.1016\/j.dadr.2023.100189","article-title":"HIV chronicity as a predictor of hippocampal memory deficits in daily cannabis users living with HIV","volume":"9","author":"Woodcock","year":"2023","journal-title":"Drug Alcohol Depend. Rep."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"364","DOI":"10.1016\/j.neuropharm.2017.02.008","article-title":"HIV-1 Vpr disrupts mitochondria axonal transport and accelerates neuronal aging","volume":"117","author":"Wang","year":"2017","journal-title":"Neuropharmacology"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"ENEURO.0547\u201320.2021","DOI":"10.1523\/ENEURO.0547-20.2021","article-title":"HIV-1 Tat and Morphine Differentially Disrupt Pyramidal Cell Structure and Function and Spatial Learning in Hippocampal Area CA1: Continuous versus Interrupted Morphine Exposure","volume":"8","author":"Marks","year":"2021","journal-title":"eNeuro"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"e35652","DOI":"10.1097\/MD.0000000000035652","article-title":"HIV-related neurocognitive disorders: Diagnosis, Treatment, and Mental Health Implications: A Review","volume":"102","author":"Elendu","year":"2023","journal-title":"Medicine"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"S38","DOI":"10.1093\/infdis\/jiac388","article-title":"Cognitive Health in Persons With Human Immunodeficiency Virus: The Impact of Early Treatment, Comorbidities, and Aging","volume":"227","author":"Aung","year":"2023","journal-title":"J. Infect. Dis."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"1647","DOI":"10.1080\/09540121.2023.2206094","article-title":"Prevalence and the associated factors of cognitive impairment among people living with HIV in Taiwan: A cross-sectional study","volume":"35","author":"Wu","year":"2023","journal-title":"AIDS Care"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"108133","DOI":"10.1016\/j.drugalcdep.2020.108133","article-title":"Getting to the point: Methamphetamine injection is associated with biomarkers relevant to HIV pathogenesis","volume":"213","author":"Miller","year":"2020","journal-title":"Drug Alcohol Depend."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1097\/QAD.0000000000002416","article-title":"Altered monocyte phenotype and dysregulated innate cytokine responses among people living with HIV and opioid-use disorder","volume":"34","author":"Underwood","year":"2020","journal-title":"AIDS"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"ofab203","DOI":"10.1093\/ofid\/ofab203","article-title":"Soluble CD163 Identifies Those at Risk for Increased Hepatic Inflammation & Fibrosis","volume":"8","author":"Sherman","year":"2021","journal-title":"Open Forum Infect. Dis."},{"key":"ref_55","doi-asserted-by":"crossref","unstructured":"Harms, R., Morsey, B., Boyer, C.W., Fox, H.S., Sarvetnick, N., and Ho, W. (2012). Methamphetamine administration targets multiple immune subsets and induces phenotypic alterations suggestive of immunosuppression. PLoS ONE, 7.","DOI":"10.1371\/journal.pone.0049897"},{"key":"ref_56","doi-asserted-by":"crossref","unstructured":"Tall\u00f3czy, Z., Martinez, J., Joset, D., Ray, Y., G\u00e1cser, A., Toussi, S., Mizushima, N., Nosanchuk, J., Goldstein, H., and Loike, J. (2008). Methamphetamine inhibits antigen processing, presentation, and phagocytosis. PLoS Pathog., 4.","DOI":"10.1371\/annotation\/bd02ad26-a081-4c61-88c2-ebda285b8bca"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"108696","DOI":"10.1016\/j.intimp.2022.108696","article-title":"Dynamics and correlations in multiplex immune profiling reveal persistent immune inflammation in male drug users after withdrawal","volume":"107","author":"Re","year":"2022","journal-title":"Int. Immunopharmacol."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1046\/j.1365-2141.2002.03790.x","article-title":"Induction of the CD163-dependent haemoglobin uptake by macrophages as a novel anti-inflammatory action of glucocorticoids","volume":"119","author":"Schaer","year":"2002","journal-title":"Br. J. Haematol."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1002\/jlb.67.1.97","article-title":"Regulation of scavenger receptor CD163 expression in human monocytes and macrophages by pro- and antiinflammatory stimuli","volume":"67","author":"Buechler","year":"2000","journal-title":"J. Leukoc. Biol."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1161\/CIRCRESAHA.109.199505","article-title":"CXCL4 downregulates the atheroprotective hemoglobin receptor cd163 in human macrophages","volume":"106","author":"Gleissner","year":"2010","journal-title":"Circ. Res."},{"key":"ref_61","doi-asserted-by":"crossref","unstructured":"Wu, H., Zhang, Z., Ma, Y., Chen, F., Xiong, P., Xie, Z., Ding, G., Yu, J., and Wang, K. (2022). Dynamic immune and exosome transcriptomic responses in patients undergoing psychostimulant methamphetamine withdrawal. Front. Cell. Neurosci., 16.","DOI":"10.3389\/fncel.2022.961131"},{"key":"ref_62","unstructured":"Hosein, M., Saylor, D., Nakigozi, G., Nakasujja, N., Kong, X., Robertson, K., Wawer, M.J., Gray, R.H., and Sacktor, N. (2015, January 23\u201326). 453. Validation of the International HIV Dementia Scale Screening Tool for HAND in Uganda. Proceedings of the Conference on Retroviruses and Opportunistic Infections (CROI), Seattle, WA, USA. Available online: https:\/\/www.croiconference.org\/wp-content\/uploads\/sites\/2\/posters\/2015\/453.pdf."},{"key":"ref_63","doi-asserted-by":"crossref","unstructured":"Atashili, J., Gaynes, B.N., Pence, B.W., Tayong, G., Kats, D., O\u2019donnell, J.K., Ndumbe, P.M., and Njamnshi, A.K. (2013). Prevalence, characteristics and correlates of a positive-dementia screen in patients on antiretroviral therapy in Bamenda, Cameroon: A cross-sectional study. BMC Neurol., 13.","DOI":"10.1186\/1471-2377-13-86"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"1094","DOI":"10.1093\/cid\/ciw416","article-title":"Impact of Opioid Substitution Therapy on Antiretroviral Therapy Outcomes: A Systematic Review and Meta-Analysis","volume":"63","author":"Low","year":"2016","journal-title":"Clin. Infect. Dis."},{"key":"ref_65","first-page":"7","article-title":"Influence of substance use and cognitive impairment on adherence to antiretroviral therapy in HIV+ patients. Adicciones","volume":"32","year":"2018","journal-title":"Adicciones"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"103281","DOI":"10.1016\/j.drugpo.2021.103281","article-title":"Adherence to antiretroviral therapy among HIV positive men who inject drugs in Pakistan","volume":"96","author":"Iversen","year":"2021","journal-title":"Int. J. Drug Policy"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"e26320","DOI":"10.1002\/jia2.26320","article-title":"Mental health and cognition in relation to adherence to antiretroviral therapy among people living with HIV in Kazakhstan: A cross-sectional study","volume":"27","author":"Mergenova","year":"2024","journal-title":"J. Int. AIDS Soc."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1097\/QAI.0000000000001305","article-title":"Impact of HIV and Atiretroviral Therapy on Neurocognitive Outcomes Among School-Aged Children","volume":"75","author":"Brahmbhatt","year":"2017","journal-title":"J. Acquir. Immune Defic. Syndr."}],"container-title":["Viruses"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1999-4915\/17\/9\/1232\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:43:03Z","timestamp":1760035383000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1999-4915\/17\/9\/1232"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,10]]},"references-count":68,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2025,9]]}},"alternative-id":["v17091232"],"URL":"https:\/\/doi.org\/10.3390\/v17091232","relation":{},"ISSN":["1999-4915"],"issn-type":[{"type":"electronic","value":"1999-4915"}],"subject":[],"published":{"date-parts":[[2025,9,10]]}}}