Associations between plasma nucleoside reverse transcriptase inhibitors concentrations and cognitive function in people with HIV.

<h4>Objectives</h4>To investigate the associations of plasma lamivudine (3TC), abacavir (ABC), emtricitabine (FTC) and tenofovir (TFV) concentrations with cognitive function in a cohort of treated people with HIV (PWH).<h4>Methods</h4>Pharmacokinetics (PK) and cognitive funct...

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Main Authors: Davide De Francesco, Xinzhu Wang, Laura Dickinson, Jonathan Underwood, Emmanouil Bagkeris, Daphne S Babalis, Patrick W G Mallon, Frank A Post, Jaime H Vera, Memory Sachikonye, Ian Williams, Saye Khoo, Caroline A Sabin, Alan Winston, Marta Boffito, Pharmacokinetic and Clinical Observations in PeoPle Over fiftY (POPPY) study
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2021-01-01
Series:PLoS ONE
Online Access:https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0253861&type=printable
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author Davide De Francesco
Xinzhu Wang
Laura Dickinson
Jonathan Underwood
Emmanouil Bagkeris
Daphne S Babalis
Patrick W G Mallon
Frank A Post
Jaime H Vera
Memory Sachikonye
Ian Williams
Saye Khoo
Caroline A Sabin
Alan Winston
Marta Boffito
Pharmacokinetic and Clinical Observations in PeoPle Over fiftY (POPPY) study
author_facet Davide De Francesco
Xinzhu Wang
Laura Dickinson
Jonathan Underwood
Emmanouil Bagkeris
Daphne S Babalis
Patrick W G Mallon
Frank A Post
Jaime H Vera
Memory Sachikonye
Ian Williams
Saye Khoo
Caroline A Sabin
Alan Winston
Marta Boffito
Pharmacokinetic and Clinical Observations in PeoPle Over fiftY (POPPY) study
author_sort Davide De Francesco
collection DOAJ
description <h4>Objectives</h4>To investigate the associations of plasma lamivudine (3TC), abacavir (ABC), emtricitabine (FTC) and tenofovir (TFV) concentrations with cognitive function in a cohort of treated people with HIV (PWH).<h4>Methods</h4>Pharmacokinetics (PK) and cognitive function (Cogstate, six domains) data were obtained from PWH recruited in the POPPY study on either 3TC/ABC or FTC/tenofovir disoproxil fumarate (TDF)-containing regimens. Association between PK parameters (AUC0-24: area under the concentration-time curve over 24 hours, Cmax: maximum concentration and Ctrough: trough concentration) and cognitive scores (standardized into z-scores) were evaluated using rank regression adjusting for potential confounders.<h4>Results</h4>Median (IQR) global cognitive z-scores in the 83 PWH on 3TC/ABC and 471 PWH on FTC/TDF were 0.14 (-0.27, 0.38) and 0.09 (-0.28, 0.42), respectively. Higher 3TC AUC0-24 and Ctrough were associated with better global z-scores [rho = 0.29 (p = 0.02) and 0.27 (p = 0.04), respectively], whereas higher 3TC Cmax was associated with poorer z-scores [rho = -0.31 (p<0.01)], independently of ABC concentrations. Associations of ABC PK parameters with global and domain z-scores were non-significant after adjustment for confounders and 3TC concentrations (all p's>0.05). None of the FTC and TFV PK parameters were associated with global or domain cognitive scores.<h4>Conclusions</h4>Whilst we found no evidence of either detrimental or beneficial effects of ABC, FTC and TFV plasma exposure on cognitive function of PWH, higher plasma 3TC exposures were generally associated with better cognitive performance although higher peak concentrations were associated with poorer performance.
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spelling doaj-art-b52a17ff99aa4d37887f8972e8ae59272025-08-20T02:23:16ZengPublic Library of Science (PLoS)PLoS ONE1932-62032021-01-01167e025386110.1371/journal.pone.0253861Associations between plasma nucleoside reverse transcriptase inhibitors concentrations and cognitive function in people with HIV.Davide De FrancescoXinzhu WangLaura DickinsonJonathan UnderwoodEmmanouil BagkerisDaphne S BabalisPatrick W G MallonFrank A PostJaime H VeraMemory SachikonyeIan WilliamsSaye KhooCaroline A SabinAlan WinstonMarta BoffitoPharmacokinetic and Clinical Observations in PeoPle Over fiftY (POPPY) study<h4>Objectives</h4>To investigate the associations of plasma lamivudine (3TC), abacavir (ABC), emtricitabine (FTC) and tenofovir (TFV) concentrations with cognitive function in a cohort of treated people with HIV (PWH).<h4>Methods</h4>Pharmacokinetics (PK) and cognitive function (Cogstate, six domains) data were obtained from PWH recruited in the POPPY study on either 3TC/ABC or FTC/tenofovir disoproxil fumarate (TDF)-containing regimens. Association between PK parameters (AUC0-24: area under the concentration-time curve over 24 hours, Cmax: maximum concentration and Ctrough: trough concentration) and cognitive scores (standardized into z-scores) were evaluated using rank regression adjusting for potential confounders.<h4>Results</h4>Median (IQR) global cognitive z-scores in the 83 PWH on 3TC/ABC and 471 PWH on FTC/TDF were 0.14 (-0.27, 0.38) and 0.09 (-0.28, 0.42), respectively. Higher 3TC AUC0-24 and Ctrough were associated with better global z-scores [rho = 0.29 (p = 0.02) and 0.27 (p = 0.04), respectively], whereas higher 3TC Cmax was associated with poorer z-scores [rho = -0.31 (p<0.01)], independently of ABC concentrations. Associations of ABC PK parameters with global and domain z-scores were non-significant after adjustment for confounders and 3TC concentrations (all p's>0.05). None of the FTC and TFV PK parameters were associated with global or domain cognitive scores.<h4>Conclusions</h4>Whilst we found no evidence of either detrimental or beneficial effects of ABC, FTC and TFV plasma exposure on cognitive function of PWH, higher plasma 3TC exposures were generally associated with better cognitive performance although higher peak concentrations were associated with poorer performance.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0253861&type=printable
spellingShingle Davide De Francesco
Xinzhu Wang
Laura Dickinson
Jonathan Underwood
Emmanouil Bagkeris
Daphne S Babalis
Patrick W G Mallon
Frank A Post
Jaime H Vera
Memory Sachikonye
Ian Williams
Saye Khoo
Caroline A Sabin
Alan Winston
Marta Boffito
Pharmacokinetic and Clinical Observations in PeoPle Over fiftY (POPPY) study
Associations between plasma nucleoside reverse transcriptase inhibitors concentrations and cognitive function in people with HIV.
PLoS ONE
title Associations between plasma nucleoside reverse transcriptase inhibitors concentrations and cognitive function in people with HIV.
title_full Associations between plasma nucleoside reverse transcriptase inhibitors concentrations and cognitive function in people with HIV.
title_fullStr Associations between plasma nucleoside reverse transcriptase inhibitors concentrations and cognitive function in people with HIV.
title_full_unstemmed Associations between plasma nucleoside reverse transcriptase inhibitors concentrations and cognitive function in people with HIV.
title_short Associations between plasma nucleoside reverse transcriptase inhibitors concentrations and cognitive function in people with HIV.
title_sort associations between plasma nucleoside reverse transcriptase inhibitors concentrations and cognitive function in people with hiv
url https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0253861&type=printable
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