COLUMBIA, SC — A new study raised alarms about the association between dementia risks in HIV patients with schizophrenia and the use of off-label antipsychotics.
The report in the Journal of Acquired Immune Deficiency Syndrome pointed out that comorbidities such as schizophrenia and medications such as antipsychotics might influence the risk of dementia among people living with HIV (PLWH).1
To assess the relationship among the factors, researchers from Dorn Research Institute at the Columbia, SC, VA Healthcare System and the College of Pharmacy at the University of South Carolina used data from VA healthcare facilities from 2000 to September 2023.
The retrospective cohort study focused on PLWH treated at the VA with prior history of schizophrenia, off-label antipsychotic use and neither schizophrenia nor antipsychotic use. Included were propensity score matched non-HIV controls.
Results indicated that PLWH with schizophrenia were found to have a 2.49 higher hazard of dementia compared to HIV patients with no history of schizophrenia or antipsychotic medication use (HR=2.49, 95%CI=(1.85-3.35)). At the same time, PLWH with off-label antipsychotic use were found to have a 1.77-fold higher hazard of dementia compared to HIV patients with no history of schizophrenia or antipsychotic medication use (HR=1.77, 95% CI=(1.37-2.28)).
“Propensity score-matched analysis reveals that, among schizophrenia patients, those with HIV had a 1.65-fold higher hazard of dementia (HR=1.65, 95% CI=1.12-2.44),” the study team explained. “Among patients with no schizophrenia or antipsychotic medication, those with HIV had a 1.47 fold higher hazard of dementia (HR=1.47, 95%CI=(1.33-1.63)).”
The researchers concluded that their findings demonstrate “that among PLWH, history of schizophrenia or off-label antipsychotic medication use are associated with substantial increases in dementia incidence. Furthermore, propensity-matched control analysis reveals that HIV infection itself is independently and significantly associated with elevated dementia risk.”
- Magagnoli J, Cummings TH, Wyatt MD, Shtutman M, Sutton SS. Schizophrenia, Off-Label Antipsychotics, and Dementia Risk in People with HIV. J Acquir Immune Defic Syndr. 2024 Oct 17. doi: 10.1097/QAI.0000000000003545. Epub ahead of print. PMID: 39418469.
