(P17-013-25) A 12-Month Longitudinal Study of Fatty Acids and Executive Function Among Adolescents With and Without Perinatally Acquired HIV in Kampala, Uganda

Objectives: The objectives were to determine associations between serum fatty acid levels and executive function in Ugandan adolescents and evaluate modification by perinatal HIV status. It was hypothesized that polyunsaturated fatty acid (PUFA) levels associated with improved executive function, while saturated fatty acid (SFA) levels associated with lower executive function, especially in adolescents affected by perinatal HIV.

Methods: Adolescents with perinatal HIV infection (APHIV, n=159), adolescents HIV exposed but uninfected (AHEU, n=155), and adolescents HIV unexposed and uninfected (AHUU, n=153) were recruited for a prospective cohort study in Kampala, Uganda. Serum fatty acids were measured at baseline. Executive function was assessed using proxy-/self-reports (Behavior Rated Inventory of Executive Function) and performance-based tests (Children’s Color Trails Test 2) at baseline, 6, and 12 months. Adjusted linear mixed models in R calculated fatty acid-tertile associated mean differences (MDs) and 95% confidence intervals (CIs) in executive dysfunction z-scores standardized by age and sex. Results are presented by perinatal HIV status if the fatty acid*HIV interaction was significant (p < 0.10).

Results: Among all adolescents, moderate v. low total ω-3 PUFA (MD [95% CI]: -0.51 [-0.87, -0.15]), Omega-3 Index (-0.53 [-0.91, -0.15]), and ω-3 docosahexaenoic acid (-0.55 [-0.92, -0.19]) predicted lower self-reported executive dysfunction. Among AHUU, high total ω-3 PUFA and low ω-6:ω-3 ratio associated with decreased performance-based dysfunction. Among APHIV, high ω-3 eicosapentaenoic acid predicted an increase (0.83 [0.05, 1.60]), whereas high levels of SFA palmitic acid predicted a decrease (-0.68 [-1.18, -0.18]), in performance-based dysfunction.

Conclusions: Higher ω-3 PUFAs predicted better questionnaire-based executive function regardless of HIV status and were beneficially associated with performance-based executive function in AHUU only. These findings suggest ω-3 PUFAs may improve executive function in populations with low PUFA intake, whereas the complex relationship between fatty acids and executive function in APHIV warrants further study for tailored interventions for populations affected by perinatal HIV.

Funding Sources: Eunice Kennedy Shriver National Institute of Child Health and Human Development