Neurologic signs and symptoms in a cohort of homosexual men followed for 4.5 years

K. Marder, X. Liu, Y. Stern, G. Dooneief, K. Bell, P. Schofield, N. Sacktor, G. Todak, R. Friedman, A. Ehrhardt, Z. Stein, J. Gorman, R. Mayeux

Research output: Contribution to journalArticlepeer-review

Abstract

We traced the development of neurologic impairment in 207 homosexual men (123 human immunodeficiency virus [HIV]-positive and 84 HIV-negative controls) over 4.5 years of follow-up. We applied generalized estimating equations to logistic regression analyses with repeated measures to examine the differences between HlV-posi- tive and HIV-negative subjects with respect to the likelihood of developing six neurologic outcomes derived from a factor analysis, significant neurologic impairment (modified Kurtzke disability score of >3), or significant neuropsychological impairment. We found that, over time, HIV-positive subjects were more likely to develop clinically significant extrapyramidal signs and frontal release signs than HIV-negative subjects. Controlling for age or education, as CD4 count declined, the odds of developing significant extrapyramidal signs, abnormalities in alternating movements, frontal release signs, and a Kurtzke score >3 increased. HIV-positive subjects were almost five times as likely (odds ratio [OR], 4.6; 95% Cl, 1.6 to 13.4) as HIV-negative subjects to stay the same or worsen neurologically on the next visit, and those with CD4 <200 were 4.8 times as likely (OR, 4.8; 95% Cl, 2.2 to 10.7) to maintain or worsen neurologically relative to those with higher CD4 counts. We conclude that neurologic impairment becomes increasingly apparent over time in HIV-infected men, especially in those with low CD4 counts.

Original languageEnglish (US)
Pages (from-to)261-267
Number of pages7
JournalNeurology
Volume45
Issue number2
DOIs
StatePublished - Feb 1995
Externally publishedYes

ASJC Scopus subject areas

  • Clinical Neurology

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