title: Cognitive functioning, wellbeing and brain correlates in HIV-1 infected patients on long-term combination antiretroviral therapy.
abstract: OBJECTIVE
  The objective of the current study is to integrate results from extensive neuropsychological assessment, subjective wellbeing reports and structural neuroimaging findings in successfully treated HIV-infected patients in comparison with a HIV-negative control group.
  
  
  METHODS
  A cross-sectional study.
  
  
  METHODS
  Neuropsychological functioning and self-reported wellbeing were assessed in a group of 102 virologically suppressed HIV-infected patients on combination antiretroviral therapy (cART) and 56 controls. Both groups underwent magnetic resonance (MR) examinations and grey matter, white matter and subcortical volumes were determined. Brain parenchymal fraction (BPF) was calculated as an estimated measure of global brain atrophy.
  
  
  RESULTS
  HIV-infected patients showed worse information processing speed (P = 0.01) and motor function (P = 0.03) than controls. Also, higher levels of anxiety and depressive symptoms, somatic and cognitive complaints, sleep problems and health distress were found, as well as lower levels of general health perceptions, social functioning and energy (P < 0.05). No differences in wellbeing reports were found between patients on regimens containing either efavirenz or nevirapine and patients on cART without these drugs (P > 0.05). Patients had a smaller BPF (P = 0.04) and thalamus (P = 0.05) than controls. A lower BPF was related to worse motor function and information processing speed in the patients. A smaller thalamus volume was related to lower motor function in the patient group and lower speed of information processing in the controls.
  
  
  CONCLUSIONS
  No profound deficits were found in the current study. The present results demonstrate that HIV has a minor impact on brain, cognition and wellbeing among HIV-infected patients who are otherwise healthy and maintained on a good control of cART.
authors.affiliation: aDepartment of Medical Psychology, Nijmegen bDepartment of Geriatric Medicine cDepartment of Radiology, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands dMedical Center for Postgraduate Education, Department of Diagnostic Imaging, Warsaw, Poland eDepartment of Internal Medicine, Radboud University Nijmegen Medical Center fDonders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, Nijmegen, The Netherlands.
authors.forename: Marloes A M
authors.initials: MA
authors.lastname: Janssen
authors.forename: Olga
authors.initials: O
authors.lastname: Meulenbroek
authors.forename: Stefan C A
authors.initials: SC
authors.lastname: Steens
authors.forename: Bozena
authors.initials: B
authors.lastname: Góraj
authors.forename: Marjolein
authors.initials: M
authors.lastname: Bosch
authors.forename: Peter P
authors.initials: PP
authors.lastname: Koopmans
authors.forename: Roy P C
authors.initials: RP
authors.lastname: Kessels
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active; D001921:Brain / Q000473:pathology / Q000502:physiology*; D003071:Cognition; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000523:psychology* / Q000821:virology; D015497:HIV-1 / Q000302:isolation & purification; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology*; D055815:Young Adult
chemical_list: D044966:Anti-Retroviral Agents