Neurocognitive Function in HIV Infected Patients on Antiretroviral Therapy
نویسندگان
چکیده
OBJECTIVE To describe factors associated with neurocognitive (NC) function in HIV-positive patients on stable combination antiretroviral therapy. DESIGN We undertook a cross-sectional analysis assessing NC data obtained at baseline in patients entering the Protease-Inhibitor-Monotherapy-Versus-Ongoing-Triple therapy (PIVOT) trial. MAIN OUTCOME MEASURE NC testing comprised of 5 domains. Raw results were z-transformed using standard and demographically adjusted normative datasets (ND). Global z-scores (NPZ-5) were derived from averaging the 5 domains and percentage of subjects with test scores >1 standard deviation (SD) below population means in at least two domains (abnormal Frascati score) calculated. Patient characteristics associated with NC results were assessed using multivariable linear regression. RESULTS Of the 587 patients in PIVOT, 557 had full NC results and were included. 77% were male, 68% Caucasian and 28% of Black ethnicity. Mean (SD) baseline and nadir CD4+ lymphocyte counts were 553(217) and 177(117) cells/µL, respectively, and HIV RNA was <50 copies/mL in all. Median (IQR) NPZ-5 score was -0.5 (-1.2/-0) overall, and -0.3 (-0.7/0.1) and -1.4 (-2/-0.8) in subjects of Caucasian and Black ethnicity, respectively. Abnormal Frascati scores using the standard-ND were observed in 51%, 38%, and 81%, respectively, of subjects overall, Caucasian and Black ethnicity (p<0.001), but in 62% and 69% of Caucasian and Black subjects using demographically adjusted-ND (p = 0.20). In the multivariate analysis, only Black ethnicity was associated with poorer NPZ-5 scores (P<0.001). CONCLUSIONS In this large group of HIV-infected subjects with viral load suppression, ethnicity but not HIV-disease factors is closely associated with NC results. The prevalence of abnormal results is highly dependent on control datasets utilised. TRIAL REGISTRY ClinicalTrials.gov, NCT01230580.
منابع مشابه
Metabolic Abnormalities in HIV-Positive Patients Receiving Highly Active Antiretroviral Therapy
Background and Objective: Dyslipidemia has become a common problem in human immunodeficiency virus (HIV) disease, especially in patients on combination antiretroviral therapy. In this study we aimed to determine the prevalence of dyslipidemia and metabolic abnormalities in 2 groups of HIV infected patients receiving highly activ...
متن کاملSLCO2B1 gene polymorphism and anti-retroviral therapy side effects in HIV-1 infected patients
Abstract Background and Objectives HIV virus and its subsequent disease is one of the most important challenges of the world health system. Although antiretroviral therapy (ART) is a breakthrough in patients’ life quality, it has complications like side effects. The side effect causes are diverse. One of the factors considered about side effects is genes polymorphism. This study investigates th...
متن کاملClinical and Para Clinical Manifestations of HIV-Positive Patients at Different Levels of CD4
Background and Objective: Human immunodeficiency virus (HIV)-infected people are at higher risk of opportunistic infections due to immunodeficiency. The current study aimed to evaluate the different levels of CD4 in HIV-infected patients and its relationship with clinical and paraclinical manifestations of the patients. Materials and Methods: This cross-sectional study was conducted on 94 HIV-...
متن کاملNeurocognitive functioning and HAART in HIV and hepatitis C virus co-infection.
OBJECTIVES This study examined the effects of HAART on neurocognitive functioning in persons with hepatitis C virus (HCV) and HIV co-infection. DESIGN A prospective study examining neurocognitive performance before and after HAART initiation. METHOD Participant groups included a mono-infected group (45 HIV+/HCV- participants) and a co-infected group (20 HIV+/HCV+ participants). A neuropsych...
متن کاملCytomegalovirus Active Infection in Persons Infected with Human Immunodeficiency Virus
Background and Objective: Cytomegalovirus (CMV), one of the most common opportunistic pathogens in patients infected with human immunodeficiency virus (HIV), can cause the diseases such as encephalitis, pneumonia, and chorioretinitis. This study aimed at molecular studying of CMV infection in individuals infected with the human immunodeficiency virus. Material and Methods: In this study, 50 ven...
متن کاملprevalence of Mycobacterium tuberculosis in patients infected with HIV by microscopical and molecular methods
Background:In some countries, one of the first and most common manifestations of HIV positive patients is tuberculosis (TB). HIV positive people are prone to other infections such as tuberculosis due to immune deficiency and reduced CD4+ cell count. Although increasing access to antiretroviral therapy has led to a reduction in HIV-related opportunistic infections and mortality, the simultaneous...
متن کامل