CROI 2025 Abstract eBook

Abstract eBook

Poster Abstracts

603

Cognitive Intra-Individual Variability Predicts IADL Function in the Women’s Interagency HIV Study David E. Vance 1 , Yanxun Xu 2 , Raha M. Dastgheyb 3 , Pauline Maki 4 , Jiayue Zhang 2 , Gayle Springer 5 , Kathryn Anastos 6 , Deborah Gustafson 7 , Kathleen M. Weber 8 , Monica M. Diaz 9 , Mirjam-Colette Kempf 1 , Deborah Konkle-Parker 10 , Karl Goodkin 11 , Matthew Wright 12 , Leah H. Rubin 5 , for the MACS/WIHS Combined Cohort Study (MWCCS) 1 University of Alabama at Birmingham, Birmingham, AL, USA, 2 The Johns Hopkins University, Baltimore, MD, USA, 3 The Johns Hopkins University School of Medicine, Baltimore, MD, USA, 4 University of Illinois at Chicago, Chicago, IL, USA, 5 The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA, 6 Albert Einstein College of Medicine, Bronx, NY, USA, 7 SUNY Downstate Medical Center, Brooklyn, NY, USA, 8 Hektoen Institute of Medicine, Chicago, IL, USA, 9 University of North Carolina at Chapel Hill, Chapel Hill, NC, USA, 10 University of Mississippi Medical Center, Jackson, MS, USA, 11 AIDS Clinical Trials Group, Los Angeles, CA, USA, 12 Harbor–UCLA Medical Center, Torrance, CA, USA Background: Cognitive intra-individual variability (IIV) refers to the variation observed in cognitive performance when various cognitive tests are administered within the same person (i.e., dispersion). In people with HIV, greater cognitive IIV has been associated with poorer cognitive performance and decline over time, cortical brain atrophy, and increased mortality risk. In this study, we calculated cognitive IIV from cognitive test performance in women with HIV (WWH) and without HIV (WWoH) and examined its relationship to everyday functioning items (i.e., cooking). Methods: This study examined the association between cognitive IIV and self-reported everyday functioning among 1,086 (WWH) and 494 socio demographically similar WWoH. Objective cognitive performance across 7 domains and the self-rated modified Lawton and Brody scale of Instrumental Activities of Daily Living (IADL) were assessed among participants of the Women’s Interagency HIV Study. Two types of cognitive IIV were calculated by taking the standard deviation across 7 cognitive domains to calculate dispersion: 1) intra-individual standard deviation (denoted as sd IIV) and 2) coefficient of variation (denoted as cov IIV). To account for the longitudinal nature of the data, generalized linear mixed effect models were conducted to examine the associations between the dispersion coefficient of cognitive IIV (predictor ( sd IIV or cov IV)) and functional status outcomes (item level scores). Models were constructed in the overall sample (WWH + WWoH), WWH only, virally suppressed (VS)-WWH, and WWoH. Results: sd IIV and cov IIV were not associated with any of the IADL items among WWoH but were for WWH and VS-WWH. At p <.05 (see Table), WWH cognitive IIV was predictive of poorer functional performance on 10 IADL items with cov IIV and 5 items with sd IIV (indicated with asterisks; money and bills, buying groceries, work, getting where you need to go, using the phone, home repairs*, dressing*, laundry*, taking/keeping track of medications*, taking care of children*). Conclusions: Several findings emerged. This study found that cognitive IIV was slightly greater among WWH compared to WWoH and predictive of everyday functioning. This study is unique in comparing two different mathematical formulae of cognitive IIV, indicating cov IIV to be more sensitive of predicting impairment in various IADLs. This means cognitive IIV, especially cov IIV, may be a predictive tool for other HIV-related behavioral phenomena.

604

Influence of an Exercise Intervention or Dynamic Stretching on Cognition and Gut Microbiome in PWH Sarah Cooley, Aura Ferreiro, Brittany Nelson, Kimberley Sukhum, June Roman, Chistopher Sorensen, Phillip Tarr, Gautam Dantas, Beau Ances Washington University in St Louis, St Louis, MO, USA Background: Gut microbiome (GM) composition and diversity is linked to cognitive performance in persons without HIV (PWoH) and can be modified with exercise. These relationships have not been examined in persons with HIV (PWH), despite PWH exhibiting a higher rate of sedentary behavior and cognitive deficits. This study examines cross-sectional relationships between physical fitness, cognition and GM; and changes in these measures after completion of a six-month aerobic and resistance exercise (EXS) or dynamic stretching (DS) intervention in PWH aged ≥40. Methods: 62 previously-sedentary PWH (77% male) completed assessments of physical fitness (cardiorespiratory testing, one-week actigraphy to measure time spent in moderate-to-vigorous physical activity [MVPA], six-minute walk test [SMWT]), cognitive testing, and a stool sample before being randomized to six months of EXS( n =44) or DS( n =18). Assessments were repeated after intervention completion. Principal coordinates analysis (PCoA) on the UniFrac distances of stool samples generated two profiles of GM composition (PCoA1, PCoA2). Faith’s phylogenetic diversity of GM was also determined. Regression analyses adjusted for sex examined baseline relationships between fitness, cognition, and GM measures. Mixed-effects linear regression models examined longitudinal change in outcomes by intervention group. Results: No significant baseline relationships were observed between fitness measures and cognition ( p’s >.05). However, greater time spent in MVPA significantly correlated with GM PCoA1 ( p =.03), and better cardiorespiratory fitness associated with greater phylogenetic diversity ( p =.03). PCoA1 correlated with learning and delayed recall ( p’s <.05), while PCoA2 correlated with executive functioning ( p =.02). Longitudinally, better SMWT, psychomotor speed, executive functioning, and global cognitive performance were observed for all participants. A significant longitudinal increase in phylogenetic diversity and change in GM composition was also observed for all participants, regardless of intervention group. Conclusions: Baseline GM composition and diversity associated with cognitive performance and fitness. Longitudinally, both EXS and DS improved physical fitness, cognitive performance, and GM composition and diversity in previously sedentary PWH, indicating that even low-impact physical activities may be beneficial. This change in GM signifies its importance as a potential therapeutic target for enhancing cognitive function or slowing cognitive decline.

Poster Abstracts

605

Longitudinal Changes in Neuronal Markers and Associations With ART Initiation and Cognitive Function Merle Henderson 1 , Peter Dutey-Magni 2 , Wolfgang Stohr 2 , Alejandro Arenas Pinto 3 , Amanda Heslegrave 2 , Henrik Zetterberg 4 , John Tregoning 5 , Andrea Calcagno 6 , Ab Babiker 2 , Alan Winston 5 1 Imperial College Healthcare NHS Trust, London, UK, 2 University College London, London, UK, 3 MRC Clinical Trials Unit at UCL, London, UK, 4 Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden, 5 Imperial College London, London, UK, 6 University of Turin, Turin, Italy Background: Improvement in cognitive function is described in persons with HIV commencing ART for the first time. We assessed the impact of initiating either dual or triple ART on longitudinal changes in biomarkers of neuronal inflammation and injury, and their associations with cognitive function. Methods: Biomarker concentrations were assessed at baseline (W0) and after 96 weeks (W96) in individuals randomised to commence darunavir/r and either tenofovir-DF/emtricitabine (triple-ART, n=119) or raltegravir (dual-ART, n=119) in a previously reported cognitive sub-study of NEAT-001/ANRS143. Plasma biomarkers assessed included neurofilament light protein (NfL), glial fibrillary acidic protein (GFAP), sCD14, CXCL10, neopterin and IL-6. Multivariable linear

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