OBJECTIVES: To describe changes in HIV-associated neurocognitive impairment in patients treated with highly active antiretroviral therapy (HAART) for at least 3 years. METHODS: Prospective, observational study of comprehensive neuropsychologic (NP) testing, neurologic examination, and laboratory measures before HAART and after 6, 15 and 45 months of HAART, on 28 consecutive patients seen in our department since April 1996. RESULTS: At baseline, 16 patients were neurocognitively impaired and 12 were not. Among the 16 impaired patients, 5 patients failed to meet the criteria for impairment after 6 months and 9 patients after both 15 and 45 months of HAART, respectively. Statistically significant improvements ( p < or =.01) were seen in two of six measures exploring the concentration and speed of mental processing, two of three measures exploring mental flexibility, in one of five measures exploring memory, and in two of two measures exploring fine motor functions. Unimpaired study subjects performed better than impaired ones in 10 of 17 measures at baseline, in eight of 17 after 6 months, in six of 17 after 15 months, and in seven of 17 after 45 months of HAART. CONCLUSIONS: During the course of HAART, patients experienced a positive and sustained improvement in their neurocognitive performance. However, the presence of 7 of 16 (43.7%) patients with neurocognitive impairment, and the persistence of statistically significant differences in the neurocognitive performance between impaired and unimpaired patients after more than 3 years of HAART, suggests that ongoing HIV-related neurologic damage can occur even during potent antiretroviral treatment.
OBJECTIVES: To describe changes in HIV-associated neurocognitive impairment in patients treated with highly active antiretroviral therapy (HAART) for at least 3 years. METHODS: Prospective, observational study of comprehensive neuropsychologic (NP) testing, neurologic examination, and laboratory measures before HAART and after 6, 15 and 45 months of HAART, on 28 consecutive patients seen in our department since April 1996. RESULTS: At baseline, 16 patients were neurocognitively impaired and 12 were not. Among the 16 impaired patients, 5 patients failed to meet the criteria for impairment after 6 months and 9 patients after both 15 and 45 months of HAART, respectively. Statistically significant improvements ( p < or =.01) were seen in two of six measures exploring the concentration and speed of mental processing, two of three measures exploring mental flexibility, in one of five measures exploring memory, and in two of two measures exploring fine motor functions. Unimpaired study subjects performed better than impaired ones in 10 of 17 measures at baseline, in eight of 17 after 6 months, in six of 17 after 15 months, and in seven of 17 after 45 months of HAART. CONCLUSIONS: During the course of HAART, patients experienced a positive and sustained improvement in their neurocognitive performance. However, the presence of 7 of 16 (43.7%) patients with neurocognitive impairment, and the persistence of statistically significant differences in the neurocognitive performance between impaired and unimpaired patients after more than 3 years of HAART, suggests that ongoing HIV-related neurologic damage can occur even during potent antiretroviral treatment.
Authors: Alan Winston; Chris Duncombe; Patrick C K Li; John M Gill; Stephen J Kerr; Rebekah L Puls; Simon D Taylor-Robinson; Sean Emery; David A Cooper Journal: Neuroradiology Date: 2012-07-07 Impact factor: 2.804
Authors: Susanne May; Scott Letendre; Richard Haubrich; J Allen McCutchan; Robert Heaton; Edmund Capparelli; Ronald Ellis Journal: J Neuroimmune Pharmacol Date: 2007-01-10 Impact factor: 4.147
Authors: Kevin Robertson; Kathy Kopnisky; James Hakim; Concepta Merry; Noeline Nakasujja; Colin Hall; Moussa Traore; Ned Sacktor; David Clifford; Charles Newton; Annelies Van Rie; Penny Holding; Janice Clements; Christine Zink; Jens Mielk; Mina Hosseinipour; Umesh Lalloo; Farida AMod; Christina Marra; Scott Evans; Jeff Liner Journal: J Neurovirol Date: 2008-04 Impact factor: 2.643
Authors: Michael Weed; Robert J Adams; Robert D Hienz; Kelly A Meulendyke; Michael E Linde; Janice E Clements; Joseph L Mankowski; M Christine Zink Journal: J Neuroimmune Pharmacol Date: 2011-05-28 Impact factor: 4.147
Authors: Lakshmanan Annamalai; Veena Bhaskar; Douglas R Pauley; Heather Knight; Kenneth Williams; Margaret Lentz; Eva Ratai; Susan V Westmoreland; R Gilberto González; Shawn P O'Neil Journal: Am J Pathol Date: 2010-07-01 Impact factor: 4.307
Authors: V G Valcour; B T Shiramizu; P Sithinamsuwan; S Nidhinandana; S Ratto-Kim; J Ananworanich; U Siangphoe; J H Kim; M de Souza; V Degruttola; R H Paul; C M Shikuma Journal: Neurology Date: 2009-03-17 Impact factor: 9.910