BACKGROUND: Few studies investigating the rate of neurocognitive (NC) impairment in effectively treated neuro-asymptomatic HIV-infected subjects have been performed. METHODS: We assessed NC function via a computerized cognitive test in HIV-infected subjects on stable combination antiretroviral therapy (cART) with plasma HIV RNA<50 copies/mL for at least 3 months. Neurologically symptomatic subjects were excluded. Current cART was evaluated for drug class (protease inhibitor [PI]- vs non-nucleoside reverse transcriptase inhibitor [NNRTI]-based) and Clinical Penetration Effectiveness (CPE) score. NC impairment was defined as a NC domain score>1 SD below mean age-matched population scores in at least 2 cognitive domains and global NC composite z-score calculated. Associations between NC scores and clinical parameters were evaluated using linear regression. RESULTS: 101 (88% male) subjects participated. Median (IQR) age was 53 (43-62) years, with current CD4+ 525 (373-710) and nadir CD4+ 185 (83-260) cells/µL. 25 subjects (25%) had chronic hepatitis C. Median (IQR) CPE score was 1.5 (1.5-2.5), and 53% were receiving NNRTI-based cART. Overall 19 (19%) subjects had NC impairment. No association between presence of NC impairment and clinical parameters were observed (P>.14, all values). Poorer global NC composite z-score was independently associated with lower nadir CD4+ lymphocyte count (P=.04) and older age (P<.001) but not other study parameters (P>.10 all values). CONCLUSION: In neuro-asymptomatic HIV-infected adults on stable cART, rates of NC impairment are low. HIV disease status (lower nadir CD4+ count) and older age, but not CPE score or cART drug class, are associated with poorer NC performance.
BACKGROUND: Few studies investigating the rate of neurocognitive (NC) impairment in effectively treated neuro-asymptomatic HIV-infected subjects have been performed. METHODS: We assessed NC function via a computerized cognitive test in HIV-infected subjects on stable combination antiretroviral therapy (cART) with plasma HIV RNA<50 copies/mL for at least 3 months. Neurologically symptomatic subjects were excluded. Current cART was evaluated for drug class (protease inhibitor [PI]- vs non-nucleoside reverse transcriptase inhibitor [NNRTI]-based) and Clinical Penetration Effectiveness (CPE) score. NC impairment was defined as a NC domain score>1 SD below mean age-matched population scores in at least 2 cognitive domains and global NC composite z-score calculated. Associations between NC scores and clinical parameters were evaluated using linear regression. RESULTS: 101 (88% male) subjects participated. Median (IQR) age was 53 (43-62) years, with current CD4+ 525 (373-710) and nadir CD4+ 185 (83-260) cells/µL. 25 subjects (25%) had chronic hepatitis C. Median (IQR) CPE score was 1.5 (1.5-2.5), and 53% were receiving NNRTI-based cART. Overall 19 (19%) subjects had NC impairment. No association between presence of NC impairment and clinical parameters were observed (P>.14, all values). Poorer global NC composite z-score was independently associated with lower nadir CD4+ lymphocyte count (P=.04) and older age (P<.001) but not other study parameters (P>.10 all values). CONCLUSION: In neuro-asymptomatic HIV-infected adults on stable cART, rates of NC impairment are low. HIV disease status (lower nadir CD4+ count) and older age, but not CPE score or cART drug class, are associated with poorer NC performance.
Authors: Alicia González-Baeza; Fernando Carvajal; Carmen Bayón; Ignacio Pérez-Valero; Miriam Estébanez; Jose I Bernardino; Susana Monge; María Lagarde; Asunción Hernando; Francisco Arnalich; José R Arribas Journal: J Neurovirol Date: 2014-04-24 Impact factor: 2.643
Authors: Claudia S Crowell; Yanling Huo; Katherine Tassiopoulos; Kathleen M Malee; Ram Yogev; Rohan Hazra; Richard M Rutstein; Sharon L Nichols; Renee A Smith; Paige L Williams; James Oleske; William J Muller Journal: AIDS Date: 2015-01-28 Impact factor: 4.177
Authors: Lewis J Haddow; Cristina Dudau; Hoskote Chandrashekar; Jonathan D Cartledge; Harpreet Hyare; Robert F Miller; H Rolf Jäger Journal: AIDS Patient Care STDS Date: 2014-05-01 Impact factor: 5.078
Authors: Rowan Saloner; Robert K Heaton; Laura M Campbell; Anna Chen; Donald Franklin; Ronald J Ellis; Ann C Collier; Christina Marra; David B Clifford; Benjamin Gelman; Ned Sacktor; Susan Morgello; J Allen McCutchan; Scott Letendre; Igor Grant; Christine Fennema-Notestine Journal: AIDS Date: 2019-06-01 Impact factor: 4.177