Keenan A. Walker|Gregory G. Brown
HIV-associated executive dysfunction in the era of modern antiretroviral therapy: A systematic review and meta-analysis
Johns Hopkins Medicine|Johns Hopkins University|University of California, San Diego
objective reports suggest hiv individuals continue display executive function ef impairment era cart findings contradictory appear differ based aspect ef measured improve understanding discrete executive abilities may differentially affected spared context hiv infection conducted systematic review metaanalysis determine whether extent hiv adults experience deficits efs b understand demographic clinical characteristics may modify associations hiv infection executive abilitiesmethod studies comparing hiv hivuninfected groups measures working memory setshifting inhibition decisionmaking apathy 2000 2017 identified three databases effect sizes cohens calculated using inverse variance weighted random effects models metaregression used examine moderating effect demographic clinical variablesresults thirtyseven studies n 3935 hiv n 2483 hivuninfected included metaanalysis pooled effect sizes deficits associated hiv infection small domains setshifting 034 95 ci 047 020 inhibition 031 95 ci 040 021 somewhat larger measures decisionmaking 041 95 ci 053 028 working memory 042 95 ci 059 029 largest apathy 087 95 ci 109 066 metaregression demonstrated age sex education current cd4 count substance dependence differentially moderated effects hiv infection specific efs however lower nadir cd4 count variable associated greater deficits nearly ef domainsconclusions results suggest discrete domains ef may differentially affected hiv infection moderating demographic clinical variables findings implications development targeted cognitive remediation strategies