title: Neurobehavioral Disturbances During Acute and Early HIV Infection.
abstract: OBJECTIVE
  Acute and early human immunodeficiency virus infection (AEH) is accompanied by neuroinflammatory processes as well as impairment in neurocognitive and everyday functions, but little is known about the frequency and clinical correlates of the neurobehavioral disturbances during this period. We compared pre-seroconversion with current levels of apathy, disinhibition, and executive dysfunction; we also examined everyday function and HIV disease correlates of neuropsychiatric impairment in individuals with AEH.
  
  
  METHODS
  In this study, 34 individuals with AEH and 39 HIV-seronegative participants completed neuromedical and neuropsychological assessments, a structured psychiatric interview, and the apathy, disinhibition, and executive dysfunction subscales of the Frontal Systems Behavioral Scale.
  
  
  RESULTS
  Independent of any substance use and mood disorders, the AEH group had significantly higher levels of current apathy and executive dysfunction than the controls, but not greater disinhibition. Retrospective ratings of pre-seroconversion levels of apathy, disinhibition, and executive dysfunction were all higher in the AEH group than the controls. After seroconversion, the AEH cohort had increases in current apathy and executive dysfunction, but not disinhibition. In the AEH cohort, higher current global neurobehavioral dysfunction was significantly associated with lower nadir CD4 counts, slowed information processing speed, and more everyday function problems.
  
  
  CONCLUSIONS
  These data suggest that individuals who have recently acquired HIV experienced higher-than-normal premorbid levels of neurobehavioral disturbance. Apathy and executive dysfunction are exacerbated during AEH, particularly in association with lower CD4 counts.
authors.affiliation: Departments of *Psychiatry ‡Medicine, University of California, San Diego, La Jolla, California †San Diego University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California §Veterans Affairs Healthcare System, San Diego, California ∥Department of Psychology, University of Houston, Houston, Texas.
authors.forename: Rujvi
authors.initials: R
authors.lastname: Kamat
authors.forename: Katie L
authors.initials: KL
authors.lastname: Doyle
authors.forename: Jennifer E
authors.initials: JE
authors.lastname: Iudicello
authors.forename: Erin E
authors.initials: EE
authors.lastname: Morgan
authors.forename: Sheldon
authors.initials: S
authors.lastname: Morris
authors.forename: Davey M
authors.initials: DM
authors.lastname: Smith
authors.forename: Susan J
authors.initials: SJ
authors.lastname: Little
authors.forename: Igor
authors.initials: I
authors.lastname: Grant
authors.forename: Steven Paul
authors.initials: SP
authors.lastname: Woods
mesh_terms: D000208:Acute Disease; D000328:Adult; D057565:Apathy; D016022:Case-Control Studies; D015331:Cohort Studies; D015897:Comorbidity; D056344:Executive Function; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology*; D006679:HIV Seropositivity / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology*; D006801:Humans; D007266:Inhibition, Psychological; D008297:Male; D008875:Middle Aged; D019964:Mood Disorders / Q000453:epidemiology / Q000523:psychology; D009483:Neuropsychological Tests; D012189:Retrospective Studies; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000523:psychology; D055815:Young Adult