Plasma viral load and CD4 lymphocytes predict HIV-associated dementia and sensory neuropathy

E. A. Childs, R. H. Lyles, O. A. Selnes, B. Chen, E. N. Miller, B. A. Cohen, J. T. Becker, J. Mellors, Justin Charles McArthur

Research output: Contribution to journalArticle

Abstract

Objective: To determine the predictive value of plasma HIV RNA and CD4 lymphocytes for HIV-associated dementia and sensory neuropathy. Methods: A total of 1,604 AIDS-free HIV seropositive men from the Multicenter AIDS Cohort Study were followed over a 10-year period (1985 to 1995). HIV- associated dementia and sensory neuropathy were diagnosed according to standard definitions. Baseline samples were used to measure plasma HIV RNA levels with a branched DNA assay and levels of β2-microglobulin, CD4 lymphocyte counts, and hemoglobin levels. Results: Seventy-seven patients with HIV-associated dementia and 213 patients with sensory neuropathy were identified. Baseline HIV RNA levels above 3,000 copies/mL and CD4 counts below 500 cells/mm3 were predictive of both neurologic outcomes, but neither hemoglobin, body mass index, nor β2-microglobulin were independently predictive. After adjusting for age and level of education, individuals with baseline plasma HIV RNA >30,000 copies/mL had a relative hazard for dementia 8.5 times (p <0.001) that of those with 3 had a 3.5-fold (p = 0.003) greater hazard relative to those with CD4 counts >500 cells/mm3. Individuals with HIV RNA >10,000 copies/mL had a 2.3-fold (p = 0.008) greater hazard of sensory neuropathy than those With 3 had a 1.4- fold (p = 0.03) greater hazard than those with >750 CD4 cells/mm3. Conclusions: High levels of systemic HIV replication may 'drive' the initiation of neurologic disease; effective suppression of HIV may reduce the incidence of dementia and neuropathy. Levels of plasma HIV RNA and CD4 counts, determined before the initiation of antiretroviral therapy, were predictive of HIV-associated dementia and sensory neuropathy.

Original languageEnglish (US)
Pages (from-to)607-613
Number of pages7
JournalNeurology
Volume52
Issue number3
StatePublished - Feb 1999

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AIDS Dementia Complex
Viral Load
HIV
Lymphocytes
RNA
CD4 Lymphocyte Count
Dementia
Acquired Immunodeficiency Syndrome
Hemoglobins
Branched DNA Signal Amplification Assay
Nervous System Diseases
Nervous System
Body Mass Index
Cohort Studies
Education

ASJC Scopus subject areas

  • Neuroscience(all)

Cite this

Childs, E. A., Lyles, R. H., Selnes, O. A., Chen, B., Miller, E. N., Cohen, B. A., ... McArthur, J. C. (1999). Plasma viral load and CD4 lymphocytes predict HIV-associated dementia and sensory neuropathy. Neurology, 52(3), 607-613.

Plasma viral load and CD4 lymphocytes predict HIV-associated dementia and sensory neuropathy. / Childs, E. A.; Lyles, R. H.; Selnes, O. A.; Chen, B.; Miller, E. N.; Cohen, B. A.; Becker, J. T.; Mellors, J.; McArthur, Justin Charles.

In: Neurology, Vol. 52, No. 3, 02.1999, p. 607-613.

Research output: Contribution to journalArticle

Childs, EA, Lyles, RH, Selnes, OA, Chen, B, Miller, EN, Cohen, BA, Becker, JT, Mellors, J & McArthur, JC 1999, 'Plasma viral load and CD4 lymphocytes predict HIV-associated dementia and sensory neuropathy', Neurology, vol. 52, no. 3, pp. 607-613.
Childs EA, Lyles RH, Selnes OA, Chen B, Miller EN, Cohen BA et al. Plasma viral load and CD4 lymphocytes predict HIV-associated dementia and sensory neuropathy. Neurology. 1999 Feb;52(3):607-613.
Childs, E. A. ; Lyles, R. H. ; Selnes, O. A. ; Chen, B. ; Miller, E. N. ; Cohen, B. A. ; Becker, J. T. ; Mellors, J. ; McArthur, Justin Charles. / Plasma viral load and CD4 lymphocytes predict HIV-associated dementia and sensory neuropathy. In: Neurology. 1999 ; Vol. 52, No. 3. pp. 607-613.
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abstract = "Objective: To determine the predictive value of plasma HIV RNA and CD4 lymphocytes for HIV-associated dementia and sensory neuropathy. Methods: A total of 1,604 AIDS-free HIV seropositive men from the Multicenter AIDS Cohort Study were followed over a 10-year period (1985 to 1995). HIV- associated dementia and sensory neuropathy were diagnosed according to standard definitions. Baseline samples were used to measure plasma HIV RNA levels with a branched DNA assay and levels of β2-microglobulin, CD4 lymphocyte counts, and hemoglobin levels. Results: Seventy-seven patients with HIV-associated dementia and 213 patients with sensory neuropathy were identified. Baseline HIV RNA levels above 3,000 copies/mL and CD4 counts below 500 cells/mm3 were predictive of both neurologic outcomes, but neither hemoglobin, body mass index, nor β2-microglobulin were independently predictive. After adjusting for age and level of education, individuals with baseline plasma HIV RNA >30,000 copies/mL had a relative hazard for dementia 8.5 times (p <0.001) that of those with 3 had a 3.5-fold (p = 0.003) greater hazard relative to those with CD4 counts >500 cells/mm3. Individuals with HIV RNA >10,000 copies/mL had a 2.3-fold (p = 0.008) greater hazard of sensory neuropathy than those With 3 had a 1.4- fold (p = 0.03) greater hazard than those with >750 CD4 cells/mm3. Conclusions: High levels of systemic HIV replication may 'drive' the initiation of neurologic disease; effective suppression of HIV may reduce the incidence of dementia and neuropathy. Levels of plasma HIV RNA and CD4 counts, determined before the initiation of antiretroviral therapy, were predictive of HIV-associated dementia and sensory neuropathy.",
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AU - Lyles, R. H.

AU - Selnes, O. A.

AU - Chen, B.

AU - Miller, E. N.

AU - Cohen, B. A.

AU - Becker, J. T.

AU - Mellors, J.

AU - McArthur, Justin Charles

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N2 - Objective: To determine the predictive value of plasma HIV RNA and CD4 lymphocytes for HIV-associated dementia and sensory neuropathy. Methods: A total of 1,604 AIDS-free HIV seropositive men from the Multicenter AIDS Cohort Study were followed over a 10-year period (1985 to 1995). HIV- associated dementia and sensory neuropathy were diagnosed according to standard definitions. Baseline samples were used to measure plasma HIV RNA levels with a branched DNA assay and levels of β2-microglobulin, CD4 lymphocyte counts, and hemoglobin levels. Results: Seventy-seven patients with HIV-associated dementia and 213 patients with sensory neuropathy were identified. Baseline HIV RNA levels above 3,000 copies/mL and CD4 counts below 500 cells/mm3 were predictive of both neurologic outcomes, but neither hemoglobin, body mass index, nor β2-microglobulin were independently predictive. After adjusting for age and level of education, individuals with baseline plasma HIV RNA >30,000 copies/mL had a relative hazard for dementia 8.5 times (p <0.001) that of those with 3 had a 3.5-fold (p = 0.003) greater hazard relative to those with CD4 counts >500 cells/mm3. Individuals with HIV RNA >10,000 copies/mL had a 2.3-fold (p = 0.008) greater hazard of sensory neuropathy than those With 3 had a 1.4- fold (p = 0.03) greater hazard than those with >750 CD4 cells/mm3. Conclusions: High levels of systemic HIV replication may 'drive' the initiation of neurologic disease; effective suppression of HIV may reduce the incidence of dementia and neuropathy. Levels of plasma HIV RNA and CD4 counts, determined before the initiation of antiretroviral therapy, were predictive of HIV-associated dementia and sensory neuropathy.

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