Background: In HIV negative population metabolic syndrome and steatosis are related
to poorer neurocognitive (NC) performance. We investigated if similar relation exists in people living
with HIV (PLWH).
Methods: We included male PLWH aged 20-65, with undetectable viral load for at least 6 months.
Data on levels of education, anthropometric measurements, CD4 levels, ART, markers of metabolic
syndrome, smoking and concurrent treatment were collected from database. Concentrations of
TNF-α and IL-6 were measured. An ultrasound was used to establish the presence of steatosis, visceral
fat thickness and carotid intima media thickness. An extensive NC assessment was done by an
experienced neuropsychologist. Cognitive domains were defined as executive functions, divergent
reasoning, visuo-constructional abilities, delayed recall and working memory and learning and were
measured using a battery of 12 tests.
Results: 88 PLWH were included (mean age 39,9 years), 51% on PIs, 46% on NNRTI; 20,4% had
metabolic syndrome, 42% patients had steatosis. Weak but statistically significant negative correlations
were found between the presence of metabolic syndrome, steatosis and VFT and cognitive
domains (divergent reasoning, delayed recall and working memory). Poorer perfomrance in the
domains of divergent reasoning and in the working memory were found in participants with steatosis
(p=0,048 and 0,033 respectively).
Conclusion: Although the sample size was relatively small, our results show consistent correlations
between the observed neurocognitive variables and metabolic parameters. As central obesity is one
of the contributors to NCI, it would be one of the modifiable factors to prevent further neurocognitive