title: Cognitive function in early HIV infection.
abstract: This study aimed to examine cognitive function in acute/early HIV infection over the subsequent 2 years. Fifty-six HIV+ subjects and 21 seronegative participants of the Chicago Early HIV Infection Study were evaluated using a comprehensive neuropsychological assessment at study enrollment and at 2-year follow-up. Cognitive performance measures were compared in the groups using t tests and mixed-effect models. Patterns of relationship with clinical measures were determined between cognitive function and clinical status markers using Spearman's correlations. At the initial timepoint, the HIV group demonstrated significantly weaker performance on measures of verbal memory, visual memory, psychomotor speed, motor speed, and executive function. A similar pattern was found when cognitive function was examined at follow-up and across both timepoints. The HIV subjects had generally weaker performance on psychomotor speed, executive function, motor speed, visual memory, and verbal memory. The rate of decline in cognitive function across the 2-year follow-up period did not differ between groups. Correlations between clinical status markers and cognitive function at both timepoints showed weaker performance associated with increased disease burden. Neurocognitive difficulty in chronic HIV infection may have very early onset and reflect consequences of initial brain viral invasion and neuroinflammation during the intense, uncontrolled viremia of acute HIV infection. Further characterization of the changes occurring in initial stages of infection and the risk and protective factors for cognitive function could inform new strategies for neuroprotection.
authors.affiliation: Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
authors.forename: Aanchal
authors.initials: A
authors.lastname: Prakash
authors.affiliation: San Diego Department of Statistics, University of California, La Jolla, CA, USA.
authors.forename: Jue
authors.initials: J
authors.lastname: Hou
authors.affiliation: Department of Preventive Medicine-Biostatistics, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
authors.forename: Lei
authors.initials: L
authors.lastname: Liu
authors.affiliation: Department of Statistics, Northwestern University, Evanston, IL, USA.
authors.forename: Yi
authors.initials: Y
authors.lastname: Gao
authors.affiliation: Department of Radiology, Feinberg School of Medicine, Northwestern University, 737 N Michigan Ave, Suite 1600, Chicago, IL, 60611, USA.
authors.forename: Casey
authors.initials: C
authors.lastname: Kettering
authors.affiliation: Department of Radiology, Feinberg School of Medicine, Northwestern University, 737 N Michigan Ave, Suite 1600, Chicago, IL, 60611, USA. ann-ragin@northwestern.edu.
authors.forename: Ann B
authors.initials: AB
authors.lastname: Ragin
mesh_terms: D000328:Adult; D003071:Cognition; D060825:Cognitive Dysfunction / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology / Q000821:virology; D018450:Disease Progression; D056344:Executive Function; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology / Q000821:virology; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008568:Memory; D009483:Neuropsychological Tests; D011597:Psychomotor Performance; D013997:Time Factors
keywords: Acute HIV; HIV-associated neurocognitive disorder; NeuroAIDs