The effects of antiretroviral treatment initiation on cognition in HIV-infected individuals with advanced disease in Pune, India.
There has been a reduction in the most severe cases of HIV-associated neurocognitive disorders (HAND) with advances in antiretroviral treatment (ART). But the prevalence of milder forms of HAND still remains high. Data from systematically conducted studies on the effects of ART on cognition are scanty in India, where HIV-1 clade C is prevalent. The purpose of the present study was to assess the effect of antiretroviral therapy in HIV-seropositive (HIV+) individuals (n = 92) with CD4 cell counts <200 cells/mm(3). The overall and domain-specific levels of cognitive functioning were determined using a locally recruited normative sample, and a change in neurocognitive functioning at the 1-year follow-up visit was analyzed. Results revealed cognitive impairment in 44.6 % of the HIV+ group at baseline. At the 1-year follow-up, the group showed significant improvement in the Learning domain (p < 0.05). HIV+ individuals showing improvement in the global cognitive scores had a significantly lower baseline CD4 cell count compared to others. Overall, the degree of improvement associated with the magnitude of rise in CD4 suggests the possibility that early, mild subclinical deficits may also benefit from treatment.
National AIDS Research Institute, Post Box 1895, G-73, MIDC, Bhosari, Pune, Maharashtra, 411026, India, mghate@nariindia.org.
Manisha
M
Ghate
Sanjay
S
Mehendale
Rachel
R
Meyer
Anya
A
Umlauf
Reena
R
Deutsch
Rujvi
R
Kamat
Madhuri
M
Thakar
Arun
A
Risbud
Smita
S
Kulkarni
Maiko
M
Sakamoto
Terry
T
Alexander
Donald
D
Franklin
Scott
S
Letendre
Robert K
RK
Heaton
Igor
I
Grant
Thomas D
TD
Marcotte
D015526:AIDS Dementia Complex / Q000188:drug therapy*; D000328:Adult; D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D018791:CD4 Lymphocyte Count; D005260:Female; D015497:HIV-1; D006801:Humans; D007194:India; D008297:Male; D009483:Neuropsychological Tests
D044966:Anti-Retroviral Agents