title: Recent clinical history and cognitive dysfunction for attention and executive function among human immunodeficiency virus-infected patients.
abstract: This study examined the association between recent trends in CD4 and viral loads and cognitive test performance with the expectation that recent history could predict cognitive performance. Eighty-three human immunodeficiency virus (HIV)-infected patients with a mean CD4 count of 428 copies/ml were examined in this study (62% with undetectable plasma viral load [PVL]). We investigated the relationships between nadir CD4 cell count, 1-year trends in immunologic function/PVLs, and cognitive performance across several domains using linear regression models. Nadir CD4 cell count was predictive of current executive function (p = .004). One year clinical history for CD4 cell counts and/or PVLs were predictive of executive function, attention/working memory, and learning/memory measures (p < .05). Models that combined recent clinical history trends and nadir CD4 cell counts suggested that recent clinical trends were more important in predicting current cognitive performance for all domains except executive function. This research suggests that recent CD4 and viral load history is an important predictor of current cognitive function across several cognitive domains. If validated, clinical variables and cognitive dysfunction models may improve our understanding of the dynamic relationships between disease evolution and progression and CNS involvement.
authors.affiliation: Center for Neurological Imaging,  Brigham and Women' s Hospital, Harvard Medical School, Boston, MA,  USA.
authors.forename: David F
authors.initials: DF
authors.lastname: Tate
authors.forename: Allison
authors.initials: A
authors.lastname: Delong
authors.forename: Daniel E
authors.initials: DE
authors.lastname: McCaffrey
authors.forename: Kinga
authors.initials: K
authors.lastname: Kertesz
authors.forename: Robert H
authors.initials: RH
authors.lastname: Paul
authors.forename: Jared
authors.initials: J
authors.lastname: Conley
authors.forename: Troy
authors.initials: T
authors.lastname: Russell
authors.forename: Kathleen
authors.initials: K
authors.lastname: Coop
authors.forename: Fizza
authors.initials: F
authors.lastname: Gillani
authors.forename: Timothy
authors.initials: T
authors.lastname: Flanigan
authors.forename: Karen
authors.initials: K
authors.lastname: Tashima
authors.forename: Joseph W
authors.initials: JW
authors.lastname: Hogan
mesh_terms: D000328:Adult; D001288:Attention; D018791:CD4 Lymphocyte Count; D003072:Cognition Disorders / Q000150:complications / Q000276:immunology / Q000523:psychology* / Q000821:virology; D018450:Disease Progression; D056344:Executive Function; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000276:immunology / Q000523:psychology* / Q000821:virology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D012044:Regression Analysis; D019562:Viral Load