Low prevalence of neurocognitive impairment in early diagnosed and managed HIV-infected persons

Nancy F. Crum-Cianflone, David J. Moore, Scott Letendre, Mollie Poehlman Roediger, Lynn Eberly, Amy Weintrob, Anuradha Ganesan, Erica Johnson, Raechel Del Rosario, Brian K. Agan, Braden R. Hale

Research output: Contribution to journalArticle

Abstract

Objective: To describe the prevalence of neurocognitive impairment (NCI) among early diagnosed and managed HIV-infected persons (HIV+) compared to HIV-negative controls. Methods: We performed a cross-sectional study among 200 HIV+ and 50 matched HIV-uninfected (HIV-) military beneficiaries. HIV+ patients were categorized as earlier (<6 years of HIV, no AIDS defining conditions, and CD4 nadir >200 cells/mm3) or later stage patients (n = 100 in each group); both groups were diagnosed early and had access to care. NCI was diagnosed using a comprehensive battery of standardized neuropsychological tests. Results: HIV+ patients had a median age of 36 years, 91% were seroconverters (median window of 1.2 years), had a median duration of HIV of 5 years, had a CD4 nadir of 319, had current CD4 of 546 cells/mm3, and 64% were on highly active antiretroviral therapy (initiated 1.3 years after diagnosis at a median CD4 of 333 cells/mm3). NCI was diagnosed among 38 (19%, 95% confidence interval 14%-25%) HIV+ patients, with a similar prevalence of NCI among earlier and later stage patients (18% vs 20%, p = 0.72). The prevalence of NCI among HIV+ patients was similar to HIV-patients. Conclusions: HIV+ patients diagnosed and managed early during the course of HIV infection had a low prevalence of NCI, comparable to matched HIV-uninfected persons. Early recognition and management of HIV infection may be important in limiting neurocognitive impairment.

Original languageEnglish (US)
Pages (from-to)371-379
Number of pages9
JournalNeurology
Volume80
Issue number4
DOIs
StatePublished - Jan 22 2013

    Fingerprint

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

Crum-Cianflone, N. F., Moore, D. J., Letendre, S., Roediger, M. P., Eberly, L., Weintrob, A., Ganesan, A., Johnson, E., Rosario, R. D., Agan, B. K., & Hale, B. R. (2013). Low prevalence of neurocognitive impairment in early diagnosed and managed HIV-infected persons. Neurology, 80(4), 371-379. https://doi.org/10.1212/WNL.0b013e31827f0776