Related Experiment Video
Updated: Jan 15, 2026
A Rat Model of EcoHIV Brain Infection
Published on: January 21, 2021
Predicting neurobehavioral outcomes in people with HIV
Ronald J Ellis1, Bin Tang2, Robert K Heaton2
1Department of Neuroscience.
Background:
This study identified complex, multidimensional, longitudinal biopsychosocial (BPS) phenotypes (MLBPSPs) in people with HIV (PWH) and evaluated their associations with baseline clinical characteristics.
Methods:
We included 506 PWH in the multisite CHARTER study who underwent assessments at four visits, 6 months apart. Participants were enrolled in the CHARTER cohort during 2003-2010, an earlier antiretroviral thearpy (ART) era in which treatment uptake and viral suppression were lower than is typical today; a prespecified sensitivity analysis examined those with sustained plasma viral suppression across visits. Using machine learning, we identified four MLBPSP clusters based on means and nonlinear trajectories of BPS characteristics. These characteristics included neurocognition, depressed mood, self-reported cognitive symptoms, and activities of daily living at each visit.
Results:
The largest MLBPSP cluster (C1, N = 231) had the best average scores across all domains and remained stable over 18 months of follow-up. Other clusters showed varying degrees of cognitive impairment, depressed mood, and functional disability. In multivariable analyses, several baseline clinical characteristics, including chronic pulmonary disease, distal neuropathic pain, polypharmacy, and creatinine levels, significantly predicted one or more adverse MLBPSP trajectories. In the sustained-suppression subgroup, the four-phenotype trajectory structure closely resembled that of the full cohort.
Conclusion:
These findings have implications for HIV care by identifying PWH at risk for future adverse trajectories. The results may lead to insights informing future personalized interventions targeted to vulnerable subpopulations of PWH. Participants were enrolled in an earlier ART era with frequent prior AIDS and lower ART uptake and viral suppression than current practice; although subgroup analyses among virally suppressed PWH showed similar directions of effect, generalizability to consistently treated contemporary cohorts may be limited and requires confirmation in modern samples.
