Longitudinal 5-year prediction of cognitive impairment among men with HIV disease

Natalia L. Oliveira*, Edward H. Kennedy, Ryan Tibshirani, Andrew Levine, Eileen Martin, Cynthia Munro, Ann B. Ragin, Leah H. Rubin, Ned Sacktor, Eric C. Seaberg, Andrea Weinstein, James T. Becker

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Background:Although combination antiretroviral therapy reduced the prevalence of HIV-associated dementia, milder syndromes persist. Our goals were to predict cognitive impairment of the Multicenter AIDS Cohort Study (MACS) participants 5 years ahead and from a large pool of factors, select the ones that mostly contributed to our predictions.Design:Longitudinal, natural and treated history of HIV infection among MSM.Methods:The MACS is a longitudinal study of the natural and treated history of HIV disease in MSM; the neuropsychological substudy aims to characterize cognitive disorders in men with HIV disease.Results:We modeled on an annual basis the risk of cognitive impairment 5 years in the future. We were able to predict cognitive impairment at individual level with high precision and overperform default methods. We found that while a diagnosis of AIDS is a critical risk factor, HIV infection per se does not necessarily convey additional risk. Other infectious processes, most notably hepatitis B and C, are independently associated with increased risk of impairment. The relative importance of an AIDS diagnosis diminished across calendar time.Conclusion:Our prediction models are a powerful tool to help clinicians address dementia in early stages for MACS paticipants. The strongest predictors of future cognitive impairment included the presence of clinical AIDS and hepatitis B or C infection. The fact that the pattern of predictive power differs by calendar year suggests a clinically critical change to the face of the epidemic.

Original languageEnglish (US)
Pages (from-to)889-898
Number of pages10
Issue number6
StatePublished - May 1 2021


  • HIV
  • cognition
  • risk prediction

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Infectious Diseases


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