Cognition and immune function in HIV-1 infection.
OBJECTIVE
To determine (1) whether there were differences in cognition between HIV-1-seropositive and HIV-1-seronegative homosexual men and (2), if so, whether these differences could be explained by the degree of immunosuppression [i.e., CD4 cell count and immunoglobulin A (IgA) levels].


METHODS
A cross-sectional design was used to compare 66 HIV-1-seropositives (Centers for Disease Control stages II and III, n = 56; stages IVA and IVC-2, n = 10) and 37 HIV-1-seronegatives. The HIV-1-seropositives were classified into three immune groups based on their CD4 cell count (x 10(6)/l) and serum IgA level (mg/dl): (1) moderate [(n = 35) CD4 greater than 400, IgA less than 300]; (2) mixed [(n = 22) either CD4 greater than 400 and IgA greater than 300 or CD4 less than 400 and IgA less than 300] and (3) poor [(n = 9) CD4 less than 400, IgA greater than 300]. HIV-1-seronegatives formed the 'good' immune group (CD4 greater than 400 and IgA less than 300).


METHODS
The four groups were compared on tests of verbal and visual memory, information-processing speeds, visuospatial skills, language processes, attention, psychomotor reaction time, and mental status. Factors other than HIV-1 sero-status that can influence cognitive performance were tested as covariates.


RESULTS
HIV-1-seropositives had slower information-processing speeds and decreased verbal and visual memory, compared with HIV-1-seronegatives. These differences in cognition were not due to differential immunosuppression or to clinical status among the HIV-1-seropositives.


CONCLUSIONS
Cognitive alterations occur in HIV-1-infected individuals before AIDS and appear to be independent of clinical status and degree of immunosuppression as measured by CD4 cell count and IgA levels.
Department of Psychiatry, University of Miami School of Medicine, FL 33136.
F L
FL
Wilkie
R
R
Morgan
M A
MA
Fletcher
N
N
Blaney
M
M
Baum
E
E
Komaroff
J
J
Szapocznik
C
C
Eisdorfer
D000328:Adult; D015496:CD4-Positive T-Lymphocytes; D003071:Cognition; D006679:HIV Seropositivity / Q000276:immunology* / Q000523:psychology*; D015497:HIV-1 / Q000276:immunology*; D006716:Homosexuality; D006801:Humans; D007070:Immunoglobulin A / Q000032:analysis; D007958:Leukocyte Count; D008297:Male
D007070:Immunoglobulin A