Table 5.
Association Between Central Nervous System Penetration Effectiveness (CPE) Score and Neurocognitive Impairment
| CPE scores ANI, MND, HAD | Unadjusted | Adjusteda | ||||
| Cross-sectional analysis (at the time of neurocognitive assessment) | ||||||
| N | 790 | 783 | ||||
| OR | 95% CI | P | OR | 95% CI | P | |
| Continuous | 1.04 | 0.96–1.13 | .364 | 1.05 | 0.94–1.16 | .398 |
| ≥7 | 1.15 | 0.79–1.67 | .477 | 1.25 | 0.79–1.96 | .338 |
| ≤5 | 0.86 | 0.39–1.89 | .710 | 0.87 | 0.34–2.25 | .774 |
| 6–8 (Ref.) | 1.0 | - | - | 1.0 | - | - |
| ≥9 | 1.11 | 0.78–1.58 | .553 | 1.21 | 0.81–1.83 | .354 |
| Cumulative analysis (entire ART duration)b | ||||||
| N | 790 | 783 | ||||
| OR | 95% CI | P | OR | 95% CI | P | |
| Continuous/T | 1.09 | 0.98–1.21 | .104 | 1.00 | 0.86–1.17 | .999 |
| ≥7/T (%) | 1.04 | 0.99–1.10 | .104 | 1.04 | 0.98–1.12 | .212 |
| ≤5/T (%) | 0.96 | 0.90–1.03 | .255 | 1.01 | 0.90–1.13 | .860 |
| ≥9/T (%) | 1.02 | 0.97–1.08 | .420 | 1.00 | 0.93–1.08 | .978 |
Abbreviations: ANI, asymptomatic neurocognitive impairment; ART, antiretroviral therapy; CI, confidence interval; CES-D, Center for Epidemiologic Studies Depression; HAD, human immunodeficiency virus-associated dementia; HIV, human immunodeficiency virus; IV, intravenous; MND, mild neurocognitive disorder; OR, odds ratio; other, non-HIV-associated neurocognitive impairment; Ref., the reference against which other categories were compared; RNA, ribonucleic acid; T, time since ART initiation.
NOTE: Odds ratios for ANI, MND, HAD, and other are shown in part A, and those for ANI, MND, and HAD are shown in part B.
aAdjustment variables: age, age [2], sex, ethnicity, education (years), T, T2, HIV transmission risk group, nadir CD4 cell count (<200, ≥200 cells/μL), proportion of time spent with plasma HIV-RNA <50 c/mL, hemoglobin (categorical variable, according to sex: < lower limit of reference range, within reference range, > upper limit of reference range), platelet count, diabetes, arterial hypertension, antecedent of cardiovascular events, cannabis consumption, cocaine consumption, past and/or actual IV drug use, CES-D scale, current efavirenz prescription, positive hepatitis C serology, positive hepatitis B serology, positive syphilis serology, CPE score at the time of neurocognitive assessment (only for cumulative CPE score analyses representing the entire ART duration).
bOdds ratios related to ≥7/T, ≤5/T, and ≥9/T thresholds express the effect of a 10% increase in the percentage of time spent in the specified category.