TY - JOUR
T1 - HIV-1 RNA concentration and cognitive performance in a cohort of HIV-positive people
AU - Vitiello, Benedetto
AU - Goodkin, Karl
AU - Ashtana, Deshratn
AU - Shapshak, Paul
AU - Atkinson, J. Hampton
AU - Heseltine, Peter N.R.
AU - Eaton, Elaine
AU - Heaton, Robert
AU - Lyman, William D.
PY - 2007/7
Y1 - 2007/7
N2 - OBJECTIVE: To determine whether higher viral concentrations in the cerebrospinal fluid (CSF) and/or peripheral blood were associated with greater severity of cognitive impairment in HIV-1-seropositive subjects with cognitive-motor impairment. METHODS: Cognitive performance measurements and viral load were obtained from HIV-1-seropositive individuals with cognitive-motor impairment entering a clinical trial before the introduction of highly active antiretroviral therapy (HAART). CSF viral load (UltraSensitive Roche HIV-1 Monitor test with detection limit of 50 copies/ml) was available from 179 patients, and peripheral (plasma or serum) viral load from 111 patients. Of these patients, 62% met the 1993 Centers for Disease Control (CDC) criteria for AIDS, and 19% had clinically significant cognitive impairment (i.e., global deficit score ≥ 0.5). Possible associations between viral load and cognitive scores were examined with general linear regression models with and without adjustment for age, education, study site, antiretroviral use, CD4 cell count, and CDC stage. RESULTS: The mean CSF viral load was 2.83 log10/ml ± 0.94 (SD) (undetectable in 19.5%). Mean peripheral viral load was 4.11 log10/ml ± 0.90 (SD). No statistically significant associations emerged between either CSF or peripheral viral load and the global deficit score, or any of the seven cognitive domain deficit scores. CONCLUSIONS: Among these HIV-1-sero-positive individuals with mainly minor HIV-1-associated cognitive deficits and not receiving HAART, no association between CSF or blood concentration of HIV-1 RNA and cognitive performance could be found. These results suggest that the severity of HIV-1-associated cognitive impairment is not directly related to concurrent viral concentration in the CSF or the peripheral blood.
AB - OBJECTIVE: To determine whether higher viral concentrations in the cerebrospinal fluid (CSF) and/or peripheral blood were associated with greater severity of cognitive impairment in HIV-1-seropositive subjects with cognitive-motor impairment. METHODS: Cognitive performance measurements and viral load were obtained from HIV-1-seropositive individuals with cognitive-motor impairment entering a clinical trial before the introduction of highly active antiretroviral therapy (HAART). CSF viral load (UltraSensitive Roche HIV-1 Monitor test with detection limit of 50 copies/ml) was available from 179 patients, and peripheral (plasma or serum) viral load from 111 patients. Of these patients, 62% met the 1993 Centers for Disease Control (CDC) criteria for AIDS, and 19% had clinically significant cognitive impairment (i.e., global deficit score ≥ 0.5). Possible associations between viral load and cognitive scores were examined with general linear regression models with and without adjustment for age, education, study site, antiretroviral use, CD4 cell count, and CDC stage. RESULTS: The mean CSF viral load was 2.83 log10/ml ± 0.94 (SD) (undetectable in 19.5%). Mean peripheral viral load was 4.11 log10/ml ± 0.90 (SD). No statistically significant associations emerged between either CSF or peripheral viral load and the global deficit score, or any of the seven cognitive domain deficit scores. CONCLUSIONS: Among these HIV-1-sero-positive individuals with mainly minor HIV-1-associated cognitive deficits and not receiving HAART, no association between CSF or blood concentration of HIV-1 RNA and cognitive performance could be found. These results suggest that the severity of HIV-1-associated cognitive impairment is not directly related to concurrent viral concentration in the CSF or the peripheral blood.
KW - Cerebrospinal fluid
KW - Cognitive impairment
KW - HIV-1
KW - Viral load
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U2 - 10.1097/QAD.0b013e328220e71a
DO - 10.1097/QAD.0b013e328220e71a
M3 - Article
C2 - 17589187
AN - SCOPUS:34250893913
SN - 0269-9370
VL - 21
SP - 1415
EP - 1422
JO - AIDS
JF - AIDS
IS - 11
ER -