title: Neurocognitive functioning in a Romanian cohort of young adults with parenterally-acquired HIV-infection during childhood.
abstract: The Romanian cohort can provide valuable information about the effect of chronic HIV-infection and exposure to combined antiretroviral therapy (cART) on the developing brain, based on its unique characteristics: young adults infected parenterally with HIV clade F in the late 1980s and exposed to cART for a decade. We conducted a prospective study using a neuropsychological test battery validated in other international HIV cohorts, in order to evaluate the rate and severity of neurocognitive impairment in a group of young Romanian adults. The 49 HIV-infected (HIV+) participants and the 20 HIV negative (HIV-) controls were similar for age and gender, although the HIV- group tended to be more educated. We found higher cognitive impairment prevalence in the HIV+ group (59.1 %) versus the HIV- group (10 %), and the impairment rate remained significantly higher even when the groups were matched based on the educational level (38.7 % for the HIV+ group vs. 10.0 % for the HIV- controls; p = 0.025). The nadir CD4 count was <200 in 71.4 % of patients, but at the time of neurocognitive assessment, 89.5 % of patients had normal immunological status and 81.8 % undetectable HIV load. Among the HIV-impaired group, 26 % of the participants had syndromic impairment while the other 74 % had asymptomatic neurocognitive impairment. We found a high prevalence of neurocognitive dysfunction in the Romanian young adults growing-up with HIV. The greatest HIV-related cognitive deficits were in the domains of executive and motor functioning, consistent with a frontosubcortical pattern.
authors.affiliation: HIV Department, "Dr. Victor Babes" Hospital for Infectious and Tropical Diseases, 281, sos. Mihai Bravu, 030303, Bucharest, Romania, luminita.ene@spitalulbabes.ro.
authors.forename: Luminita
authors.initials: L
authors.lastname: Ene
authors.forename: Donald R
authors.initials: DR
authors.lastname: Franklin
authors.forename: Ruxandra
authors.initials: R
authors.lastname: Burlacu
authors.forename: Anca E
authors.initials: AE
authors.lastname: Luca
authors.forename: Andreea G
authors.initials: AG
authors.lastname: Blaglosov
authors.forename: Ronald J
authors.initials: RJ
authors.lastname: Ellis
authors.forename: Terry J
authors.initials: TJ
authors.lastname: Alexander
authors.forename: Anya
authors.initials: A
authors.lastname: Umlauf
authors.forename: Igor
authors.initials: I
authors.lastname: Grant
authors.forename: Dan C
authors.initials: DC
authors.lastname: Duiculescu
authors.forename: Cristian L
authors.initials: CL
authors.lastname: Achim
authors.forename: Thomas D
authors.initials: TD
authors.lastname: Marcotte
mesh_terms: D000293:Adolescent; D003072:Cognition Disorders / Q000453:epidemiology* / Q000821:virology*; D015331:Cohort Studies; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D015995:Prevalence; D012383:Romania / Q000453:epidemiology; D055815:Young Adult