Primitive reflexes in a case-control study of patients with advanced human immunodeficiency virus type 1.
This study estimated the frequency of nine primitive reflexes (PR) and assessed their possible clinical value in a group of patients with acquired immunodeficiency syndrome. We studied 78 patients with human inmunodeficiency type 1 (HIV-1) infection in WHO clinical stage 3 or 4 and 81 matched seronegative controls. All participants were examined using a standardized neurological examination and the Mini-Mental State Examination. Cognitive impairment and PR was found in 36% of patients but in none of the controls (P<0.0001; logistic regression odds ratio: 14.7). Overall, PR were 2-36 times more frequent in patients with HIV-1 infection. This association was stronger for the glabellar, snout, Rossolimo, and digital signs. At least two PR were observed in 92% of patients vs. 8% of controls (P<0.0001; 95% confidence interval: 68%-100%; logistic regression odds ratio: 10.8). These data support the association of PR with cognitive decline in patients with advanced HIV-1 infection without overt neurological disease. Larger follow-up studies with multivariate techniques are needed to identify which PRs are useful as indicators of HIV-1-associated cognitive/motor complex and minor neurocognitive disorders.
Tremont-Lukats
I W
IW
Department of Neurology, University of Wisconsin Hospital and Clinics, Madison 53792-5132, USA. itremont@facstaff.wisc.edu
Teixeira
G M
GM
Hernández
D E
DE
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications* / Q000503:physiopathology / Q000523:psychology; D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D003071:Cognition; D003937:Diagnosis, Differential; D005260:Female; D015497:HIV-1 / Q000472:pathogenicity*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009460:Neurologic Examination; D012018:Reflex / Q000502:physiology*