Combination antiretroviral therapy improves psychomotor speed performance in HIV-seropositive homosexual men

N. C. Sacktor, R. H. Lyles, R. L. Skolasky, D. E. Anderson, J. C. McArthur, G. McFarlane, O. A. Seines, J. T. Becker, B. Cohen, J. Wesch, E. N. Miller

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Combination antiretroviral therapy including protease inhibitors (combo+PI) is effective in suppressing systemic vital load in HIV infection, but its impact on HIV-associated cognitive impairment is unclear. Objective: To determine whether psychomotor speed, a sensitive measure of impairment in HIV dementia, improves with combo+PI compared with other antiretroviral treatments. Methods: A total of 411 HIV-seropositive (HIV+) homosexual men (with longitudinal neuropsychological testing) in the Multicenter AIDS Cohort Study and, in a separate analysis, 282 HIV+ homosexual men with psychomotor slowing at baseline were classified by treatment into four groups: antiretroviral naive (no antiretroviral medication treatment), monotherapy, combination antiretroviral therapy without protease inhibitors (combo-noPI), and combo+PI. We compared longitudinal performance on three tests of psychomotor speed: the Grooved Pegboard (GP) (nondominant and dominant hands), Trail Making Test B, and the Symbol Digit Modalities Test (SDMT). Results: Relative to antiretroviral- naive and monotherapy participants, on the GP nondominant hand test, combo+PI participants with abnormal baseline neuropsychological testing showed improved performance (difference = +0.63 standard deviation [SD], p = 0.02). For the SDMT, both combo+PI participants (difference = +0.26 SD, p = 0.03) and combo-noPI participants (difference = +0.29 SD, p = 0.01) with abnormal baseline neuropsychological testing improved compared with antiretroviral- naive and monotherapy groups. Conclusion: Combo+PI and combo-noPI are associated with improved psychomotor speed performance in HIV+ homosexual men with abnormal neuropsychological testing.

Original languageEnglish (US)
Pages (from-to)1640-1647
Number of pages8
JournalNeurology
Volume52
Issue number8
DOIs
StatePublished - May 12 1999

ASJC Scopus subject areas

  • Clinical Neurology

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