Highly active antiretroviral treatment in HIV infection: benefits for neuropsychological function.
OBJECTIVE
To determine whether highly active antiretroviral therapy (HAART) is associated with reduced HIV-associated neuropsychological impairment.


METHODS
Cross-sectional analysis in a natural history study of adaptation to HIV/AIDS.


METHODS
A sample of 130 homo-/bisexual men with HIV/AIDS (mean age, 41 years; 42% non-white) were evaluated with a neuropsychological battery assessing attention, concentration, psychomotor speed, learning, memory and executive function. Subjects taking HAART were compared with those not taking HAART on demographics, CD4 cell count, viral load, scores on individual neuropsychological tests and proportion with neuropsychological impairment.


RESULTS
Sixty-nine (53%) subjects were taking HAART, and 48 (37%) were neuropsychologically impaired. Subjects taking HAART had lower mean CD4 cell counts than those not taking HAART (254 versus 342 x 10(6)/l; P < 0.05), although they were more likely to have undetectable viral load (42 versus 20%; P < 0.01) and were less likely to be neuropsychologically impaired (22 versus 54%; P < 0.0001). Subjects taking HAART performed significantly better on tests of attention, concentration, learning, memory, and psychomotor speed. After excluding subjects with potential non-HIV confounders of neuropsychological function, those without neuropsychological impairment had significantly lower mean viral load levels and were more likely to have undetectable viral load than those with impairment.


CONCLUSIONS
These preliminary findings suggest that HAART benefits neuropsychological function through the reduction of viral load.
Ferrando
S
S
HIV Clinical Research Program, Cornell University Medical College, New York, New York 10021, USA.
van Gorp
W
W
McElhiney
M
M
Goggin
K
K
Sewell
M
M
Rabkin
J
J
D000328:Adult; D000367:Age Factors; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D018791:CD4 Lymphocyte Count; D003430:Cross-Sectional Studies; D004359:Drug Therapy, Combination; D004522:Educational Status; D005006:Ethnicity; D015658:HIV Infections / Q000188:drug therapy* / Q000523:psychology*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008606:Mental Processes / Q000187:drug effects*; D009483:Neuropsychological Tests; D011237:Predictive Value of Tests; D011597:Psychomotor Performance / Q000187:drug effects*; D012367:RNA, Viral / Q000097:blood; D019562:Viral Load
D019380:Anti-HIV Agents; D012367:RNA, Viral