title: Apathy correlates with cognitive function but not CD4 status in patients with human immunodeficiency virus.
abstract: Apathy is a prominent neuropsychiatric symptom associated with human immunodeficiency virus (HIV). The increased frequency of apathy in this population may reflect the direct involvement of the virus on the central nervous system (CNS), but the severity of apathy has not been shown to consistently relate to markers of disease activity or other neuropsychiatric complications of the virus. We examined the relationship between ratings of apathy and performance on measures of cognitive function and immune system status in a sample of HIV-infected patients. Apathy was significantly elevated among HIV-infected individuals compared to healthy comparison subjects. Apathy was significantly related to performance on measures of learning efficiency and a measure of cognitive flexibility. Ratings of apathy did not relate to CD4 cell count, but they were associated with disease duration. In addition, ratings of depression were independent of ratings of apathy. These findings suggest that apathy does not co-vary with a proxy measure of active disease status, but apathy does relate to several measures of cognitive dysfunction in patients with HIV. As such, the increased prevalence of apathy among HIV-infected adults may reflect HIV-associated neurologic dysfunction.
authors.affiliation: Brown Medical School, Department of Psychiatry and Human Behavior, Center for AIDS Research & Centers for Behavioral and Preventive Medicine, 1 Hoppin Street, Providence, RI 02903, USA. RPaul@Lifespan.org
authors.forename: Robert
authors.initials: R
authors.lastname: Paul
authors.forename: Timothy P
authors.initials: TP
authors.lastname: Flanigan
authors.forename: Karen
authors.initials: K
authors.lastname: Tashima
authors.forename: Ronald
authors.initials: R
authors.lastname: Cohen
authors.forename: Jay
authors.initials: J
authors.lastname: Lawrence
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Alt
authors.forename: David
authors.initials: D
authors.lastname: Tate
authors.forename: Corrine
authors.initials: C
authors.lastname: Ritchie
authors.forename: Charles
authors.initials: C
authors.lastname: Hinkin
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D018791:CD4 Lymphocyte Count / Q000706:statistics & numerical data; D015496:CD4-Positive T-Lymphocytes / Q000378:metabolism*; D003072:Cognition Disorders / Q000097:blood / Q000523:psychology*; D003863:Depression / Q000097:blood / Q000523:psychology; D015658:HIV Infections / Q000097:blood / Q000523:psychology*; D006801:Humans; D008875:Middle Aged; D009042:Motivation; D009483:Neuropsychological Tests / Q000706:statistics & numerical data