HIV suppression by HAART preserves cognitive function in advanced, immune-reconstituted AIDS patients.

摘要: Introduction HIV can damage neurons leading to cognitive impairment. Epidemiological observations suggest that neuropsychological impairment might progress despite successful HAART therapy, but available prevalence estimates are based on populations were selected for Methods Of 433 advanced AIDS patients with documented immune reconstitution (CD4 lymphocyte counts 100 cells/microl after HAART), 286 had brief assessments of cognition (Trailmaking A/B and Digit Symbol Tests) at least once, no confounding neurological conditions, norms comprehensive demographic corrections. At entry, most reconstituted (median CD4 cell count 230 cells/microl) was suppressed (65% 20 000 RNA copies/ml). Results Over one quarter (27%) participants exhibited their initial assessment, a rate nearly twice expected in normal (HIV-uninfected) reference population (14%). These impaired did not differ from the unimpaired group respect age, sex, education, race, counts, or HIV-RNA levels. Improved performance tests over 2-year period 3-5 years initiating HAART. This improvement marginally associated continued improving control plasma levels, concurrent levels recovery counts). Conclusion Most responding prolonged periods have stable cognition, remain more likely be than general population. During HAART, test probably reflects both practice effects continuing 3