An exploratory study of long-term neurocognitive outcomes following recovery from opportunistic brain infections in HIV+ adults.
Central nervous system opportunistic infections (CNS-OI) are a significant cause of morbidity and mortality in AIDS. While current interventions are increasingly successful in treating CNS-OI, little information exists regarding long-term behavioral outcomes among survivors. In this exploratory study we examined neurocognitive data among three groups of adults with different AIDS-related CNS-OI: 15 with past cryptococcal meningitis (CM), 8 with toxoplasmosis encephalitis (TE), and 8 with progressive multifocal leukoencephalopathy (PML). A group of 61 individuals with AIDS, but without CNS-OI, was used as a comparison group. A battery of standardized neuropsychological tests assessing a variety of cognitive domains was administered upon entry. Results indicate that individuals with a history of CNS-OI were most impaired on measures of cognitive and psychomotor speed relative to the HIV+ comparison group. Among the CNS-OI groups, individuals with history of TE had the most severe and varied deficits. The results are discussed in relation to what is known about the neuropathological consequences of the various CNS-OIs. While this is the first systematic group study of residual CNS-OI effects on neurocognitive function, future studies employing more participants, perhaps focusing on specific CNS-OIs, will further characterize the long-term outcomes in AIDS-related CNS-OI.
Levine
Andrew J
AJ
Los Angeles-National Neurological AIDS Bank, University of California, Los Angeles, CA 90025, USA. ajlevine@mednet.ucla.edu
Hinkin
Charles H
CH
Ando
Kazuhiro
K
Santangelo
Gianni
G
Martinez
Mariana
M
Valdes-Sueiras
Miguel
M
Saxton
Ernestina H
EH
Mathisen
Glen
G
Commins
Deborah L
DL
Moe
Ardis
A
Farthing
Charles
C
Singer
Elyse J
EJ
D000328:Adult; D000704:Analysis of Variance; D003072:Cognition Disorders / Q000209:etiology* / Q000821:virology; D003431:Cross-Cultural Comparison; D003586:Cytomegalovirus Infections / Q000473:pathology / Q000821:virology; D018792:Encephalitis, Viral / Q000150:complications* / Q000209:etiology*; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008606:Mental Processes / Q000502:physiology; D008875:Middle Aged; D009460:Neurologic Examination / Q000379:methods; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales; D020127:Recovery of Function / Q000502:physiology*; D016781:Toxoplasmosis, Cerebral / Q000473:pathology / Q000821:virology