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Both HIV infection and methamphetamine dependence can be associated
with brain dysfunction. Little is known, however, about the cognitive
effects of concurrent HIV infection and methamphetamine dependence. The
present study included 200 participants in 4 groups: HIV
infected/methamphetamine dependent (HIV+/METH+), HIV
negative/methamphetamine dependent (HIV−/METH+), HIV
infected/methamphetamine nondependent (HIV+/METH−), and
HIV negative/methamphetamine nondependent
(HIV−/METH−). Study groups were comparable for age,
education, and ethnicity, although the HIV−/METH− group
had significantly more females. A comprehensive, demographically
corrected neuropsychological battery was administered yielding a global
performance score and scores for seven neurobehavioral domains. Rates
of neuropsychological impairment were determined by cutoff scores
derived from performances of a separate control group and validated
with larger samples of HIV+ and HIV− participants from an
independent cohort. Rates of global neuropsychological impairment were
higher in the HIV+/METH+ (58%), HIV−/METH+ (40%) and
HIV+/METH− (38%) groups compared to the
HIV−/METH− (18%) group. Nonparametric analyses revealed
a significant monotonic trend for global cognitive status across
groups, with least impairment in the control group and highest
prevalence of impairment in the group with concurrent HIV infection and
methamphetamine dependence. The results indicate that HIV infection and
methamphetamine dependence are each associated with neuropsychological
deficits, and suggest that these factors in combination are associated
with additive deleterious cognitive effects. This additivity may
reflect common pathways to neural injury involving both cytotoxic and
apoptotic mechanisms. (JINS, 2004, 10,
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