title: Neurologic Manifestations<br />of HIV Infection Without AIDS:Follow-UP of a Cohort<br />of Homosexual and Bisexual Men.
abstract: To identify neurological abnormalities in HIV infection, 159 HIV-seropositive men without AIDS and 76 seronegative controls underwent standardized general and neurological examinations, lumbar puncture (LP), neuropsychological (NP) assessment, and brain magnetic resonance (MR) imaging. History, physical, and laboratory evaluations were repeated every six months. NP tests (all subjects) and MR imaging (seropositives only) was repeated every 6-12 months; LP (seropositives only) was repeated yearly. Mean follow-up was 24.6 months. Neurological abnormalities, most related to hearing, were seen in 60 (38.2%) of 157 seropositives and 23 (30.3%) of 76 controls at baseline (p = NS). During follow-up, 43 (31.6%) of 136 seropositives had persistent hearing abnormalities compared to 9 (14.1%) of 64 seronegatives (p = 0.008). Seven HIV-seropositives developed peripheral neuropathy; this was more common among those with hearing abnormalities (p = 0.03). HIV-seropositives performed less well on NP tests than controls, but overall performance did not decline. Worsening brain atrophy by MR imaging or cerebrospinal fluid abnormalities are more common in HIV-seropositives than seronegatives and may share a common mechanism with peripheral neuropathy. Further study is needed to determine whether these abnormalities portend more serious neurological disease.
authors.affiliation: , Harborview Medical Center, Neurology ZA-95, 325 9th Avenue, Seattle, WA, 98104-2499.
authors.forename: C M
authors.initials: CM
authors.lastname: Marra
authors.forename: W T
authors.initials: WT
authors.lastname: Longstreth
authors.forename: H H
authors.initials: HH
authors.lastname: Handsfield
authors.forename: B D
authors.initials: BD
authors.lastname: Townes
authors.forename: R W
authors.initials: RW
authors.lastname: Coombs
authors.forename: V L
authors.initials: VL
authors.lastname: Murphy
authors.forename: A C
authors.initials: AC
authors.lastname: Collier
authors.forename: C L
authors.initials: CL
authors.lastname: Maxwell
authors.forename: K
authors.initials: K
authors.lastname: Claypoole
authors.forename: K R
authors.initials: KR
authors.lastname: Maravilla
authors.forename: R
authors.initials: R
authors.lastname: Sloan
authors.forename: W A
authors.initials: WA
authors.lastname: Cohen
authors.forename: S B
authors.initials: SB
authors.lastname: Ross
mesh_terms: D000163:Acquired Immunodeficiency Syndrome; D001727:Bisexuality; D005500:Follow-Up Studies; D015658:HIV Infections; D006679:HIV Seropositivity / Q000523:psychology; D006716:Homosexuality; D006801:Humans; D008297:Male; D009460:Neurologic Examination