Impact of apolipoprotein E ε4 and HIV on cognition and brain atrophy: Antagonistic pleiotropy and premature brain aging

► APOEε4 allele is associated with greater brain atrophy in HIV+ individuals. ► HIV subjects with APOEε4 allele(s) performed worse on most cognitive tests. ► Younger but not older HIV+ individuals are affected by having the ε4 allele(s). ► APOEε4 allele(s) may contribute to neurodegeneration in younger HIV patients.