title: Low prevalence of neurocognitive impairment in early diagnosed and managed HIV-infected persons.
abstract: OBJECTIVE
  To describe the prevalence of neurocognitive impairment (NCI) among early diagnosed and managed HIV-infected persons (HIV+) compared to HIV-negative controls.
  
  
  METHODS
  We performed a cross-sectional study among 200 HIV+ and 50 matched HIV-uninfected (HIV-) military beneficiaries. HIV+ patients were categorized as earlier (<6 years of HIV, no AIDS-defining conditions, and CD4 nadir >200 cells/mm(3)) or later stage patients (n = 100 in each group); both groups were diagnosed early and had access to care. NCI was diagnosed using a comprehensive battery of standardized neuropsychological tests.
  
  
  RESULTS
  HIV+ patients had a median age of 36 years, 91% were seroconverters (median window of 1.2 years), had a median duration of HIV of 5 years, had a CD4 nadir of 319, had current CD4 of 546 cells/mm(3), and 64% were on highly active antiretroviral therapy (initiated 1.3 years after diagnosis at a median CD4 of 333 cells/mm(3)). NCI was diagnosed among 38 (19%, 95% confidence interval 14%-25%) HIV+ patients, with a similar prevalence of NCI among earlier and later stage patients (18% vs 20%, p = 0.72). The prevalence of NCI among HIV+ patients was similar to HIV- patients.
  
  
  CONCLUSIONS
  HIV+ patients diagnosed and managed early during the course of HIV infection had a low prevalence of NCI, comparable to matched HIV-uninfected persons. Early recognition and management of HIV infection may be important in limiting neurocognitive impairment.
authors.affiliation: Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences, Bethesda, MD, USA. nancy.crum@med.navy.mil
authors.forename: Nancy F
authors.initials: NF
authors.lastname: Crum-Cianflone
authors.forename: David J
authors.initials: DJ
authors.lastname: Moore
authors.forename: Scott
authors.initials: S
authors.lastname: Letendre
authors.forename: Mollie
authors.initials: M
authors.lastname: Poehlman Roediger
authors.forename: Lynn
authors.initials: L
authors.lastname: Eberly
authors.forename: Amy
authors.initials: A
authors.lastname: Weintrob
authors.forename: Anuradha
authors.initials: A
authors.lastname: Ganesan
authors.forename: Erica
authors.initials: E
authors.lastname: Johnson
authors.forename: Raechel
authors.initials: R
authors.lastname: Del Rosario
authors.forename: Brian K
authors.initials: BK
authors.lastname: Agan
authors.forename: Braden R
authors.initials: BR
authors.lastname: Hale
mesh_terms: D015526:AIDS Dementia Complex / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D000293:Adolescent; D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active / Q000706:statistics & numerical data; D018791:CD4 Lymphocyte Count / Q000706:statistics & numerical data; D003072:Cognition Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000821:virology; D015897:Comorbidity; D003430:Cross-Sectional Studies; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008889:Military Personnel / Q000706:statistics & numerical data; D009483:Neuropsychological Tests; D015995:Prevalence; D012307:Risk Factors; D055815:Young Adult
chemical_list: D019380:Anti-HIV Agents