title: Neurocognitive functioning in antiretroviral therapy-naïve youth with behaviorally acquired human immunodeficiency virus.
abstract: OBJECTIVE
  Youth living with human immunodeficiency virus (HIV) account for over one third of new HIV infections and are at high risk of adverse psychosocial, everyday living, and health outcomes. Human immunodeficiency virus-associated neurocognitive disorders (HAND) are known to affect health outcomes of HIV-infected adults even in the era of combination antiretroviral therapy. Thus, the current study aimed to characterize the prevalence and clinical correlates of HAND in youth living with HIV. Here, we report baseline neurocognitive data for behaviorally HIV-infected youth enrolled in a prospective study evaluating strategies of antiretroviral treatment initiation and use.
  
  
  METHODS
  A total of 220 participants, age 18-24 years, who were naive to treatment (except for prevention of mother-to-child HIV transmission; n = 3), completed a comprehensive neurocognitive, substance use, and behavioral health assessment battery.
  
  
  RESULTS
  Sixty-seven percent of youth met criteria for HAND (96.4% were asymptomatic and 3.5% were syndromic); deficits in episodic memory and fine-motor skills emerged as the most commonly affected ability areas. Multivariable models showed that lower CD4 count, longer time since HIV diagnosis, and high-risk alcohol use were uniquely associated with neurocognitive deficits.
  
  
  CONCLUSIONS
  Over two thirds of youth with behaviorally acquired HIV evidence neurocognitive deficits, which have modest associations with more advanced HIV disease as well as other factors. Research is needed to determine the impact of such neuropsychiatric morbidity on mental health and HIV disease treatment outcomes (e.g., nonadherence) and transition to independent living responsibilities in HIV-infected youth, as well as its long-term trajectory and possible responsiveness to cognitive rehabilitation and pharmacotherapy.
authors: Department of Neurosciences, University of California, San Diego, La Jolla, California. Electronic address: slnichols@ucsd.edu.
authors: Sharon L
authors: SL
authors: Nichols
authors: James
authors: J
authors: Bethel
authors: Patricia A
authors: PA
authors: Garvie
authors: Doyle E
authors: DE
authors: Patton
authors: Sarah
authors: S
authors: Thornton
authors: Bill G
authors: BG
authors: Kapogiannis
authors: Weijia
authors: W
authors: Ren
authors: Hanna
authors: H
authors: Major-Wilson
authors: Ana
authors: A
authors: Puga
authors: Steven P
authors: SP
authors: Woods
mesh_terms: D000293:Adolescent; D023241:Antiretroviral Therapy, Highly Active; D003072:Cognition Disorders / Q000208:ethnology / Q000821:virology*; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology / Q000208:ethnology; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D017410:Practice Guidelines as Topic; D015995:Prevalence; D011446:Prospective Studies; D011647:Puerto Rico; D019966:Substance-Related Disorders / Q000150:complications / Q000208:ethnology; D014481:United States; D055815:Young Adult
keywords: Adolescent; HIV; HIV-associated neurocognitive disorder; Neurocognitive functioning; Substance use
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