title: Sustained cognitive decline in HIV infection: relationship to CD4+ cell count, plasma viremia and p24 antigenemia.
abstract: To determine the clinical and virological correlates of neuropsychological test performance decline in HIV infection, we measured viral burden in blood in 272 HIV-seropositive men without dementia in the Baltimore arm of the Multicenter AIDS Cohort Study (MACS). These measures were then related to neuropsychological (NP) decline, defined as a decline relative to prior best performance of 2.0 standard deviations or more on one or more neuropsychological tests. A short battery of NP tests (Mini-Screen Battery) was administered to all 272 men. NP test performance decline was identified in 53/272 (19.5%) of participants on the Mini-Screen Battery. Follow-up NP data were available for 204 participants who had undergone the Mini-Screen. The frequency of sustained NP test performance decline was 7.8% for the Mini-Screen Battery. A lower CD4+ cell count was weakly associated with sustained NP test performance decline. After adjustment for CD4+ cell count, hemoglobin, body mass index, and presence of AIDS, none of the viral burden measures (p24 antigenemia, plasma viremia, quantitative culture) correlated with sustained NP test performance decline. We conclude that these measures of blood HIV viral burden are not markers for NP decline, but that a lower CD4+ cell count is.
authors.affiliation: Department of Neurology, Johns Hopkins University, Baltimore, Maryland, USA.
authors.forename: G J
authors.initials: GJ
authors.lastname: Dal Pan
authors.forename: H
authors.initials: H
authors.lastname: Farzadegan
authors.forename: O
authors.initials: O
authors.lastname: Selnes
authors.forename: D R
authors.initials: DR
authors.lastname: Hoover
authors.forename: E N
authors.initials: EN
authors.lastname: Miller
authors.forename: R L
authors.initials: RL
authors.lastname: Skolasky
authors.forename: T E
authors.initials: TE
authors.lastname: Nance-Sproson
authors.forename: J C
authors.initials: JC
authors.lastname: McArthur
mesh_terms: D015526:AIDS Dementia Complex / Q000188:drug therapy / Q000276:immunology* / Q000821:virology*; D000328:Adult; D000998:Antiviral Agents / Q000008:administration & dosage; D018791:CD4 Lymphocyte Count; D015496:CD4-Positive T-Lymphocytes; D016655:HIV Core Protein p24 / Q000097:blood* / Q000302:isolation & purification; D015497:HIV-1; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D014766:Viremia / Q000188:drug therapy / Q000276:immunology* / Q000821:virology*; D015215:Zidovudine / Q000008:administration & dosage
chemical_list: D000998:Antiviral Agents; D016655:HIV Core Protein p24; D015215:Zidovudine