HIV and vascular disease confer additive effects on apathy.

Apathy occurs in approximately one-third of people with HIV (PWH) and adversely affects everyday functioning, but we know little about the role of modifiable contributors to its expression. The present study examined whether vascular disease, which is commonly comorbid with HIV, plays a role in the frequency and severity of apathy among PWH. Participants in this cross-sectional, between-groups study included 319 PWH and 133 people without HIV who completed a research medical examination alongside self-report measures of apathy and other psychiatric symptoms from which normatively adjusted composite scores were derived. Vascular disease was operationalized as the presence of current or historical cardiovascular conditions. A multiple regression covarying for education and psychiatric conditions showed that HIV and vascular disease were both independently predictive of the severity of apathy symptoms. Clinically elevated apathy was present in 52.1% of the people with comorbid HIV and vascular disease, 39.8% of people with either HIV or vascular disease, and 21% of people with neither condition. Vascular disease contributes to the frequency and severity of apathy in PWH. Future studies are needed to understand the potential neurobiological mechanisms of this association and whether lifestyle factors (e.g., physical activity) improve apathy among PWH.