The prevalence and incidence of neurocognitive impairment in the HAART era

Kevin R. Robertson, Marlene Smurzynski, Thomas D. Parsons, Kunling Wu, Ronald J. Bosch, Julia Wu, Justin Charles McArthur, Ann C. Collier, Scott R. Evans, Ron J. Ellis

Research output: Contribution to journalArticle

Abstract

OBJECTIVES: HAART suppresses HIV viral replication and restores immune function. The effects of HAART on neurological disease are less well understood. The aim of this study was to assess the prevalence and incidence of neurocognitive impairment in individuals who initiated HAART as part of an AIDS clinical trial. DESIGN: A prospective cohort study of HIV-positive patients enrolled in randomized antiretroviral trials, the AIDS Clinical Trials Group (ACTG) Longitudinal Linked Randomized Trials (ALLRT) study. METHODS: We examined the association between baseline and demographic characteristics and neurocognitive impairment among 1160 subjects enrolled in the ALLRT study. RESULTS: A history of immunosuppression (nadir CD4 cell count <200 cells/μl) was associated with an increase in prevalent neurocognitive impairment. There were no significant virological and immunological predictors of incident neurocognitive impairment. Current immune status (low CD4 cell count) was associated with sustained prevalent impairment. CONCLUSION: The association of previous advanced immunosuppression with prevalent and sustained impairment suggests that there is a non-reversible component of neural injury that tracks with a history of disease progression. The association of sustained impairment with worse current immune status (low CD4 cell count) suggests that restoring immunocompetence increases the likelihood of neurocognitive recovery. Finally, the lack of association between incident neurocognitive impairment and virological and immunological indicators implies that neural injury continues in some patients regardless of the success of antiretroviral therapy on these laboratory measures.

Original languageEnglish (US)
Pages (from-to)1915-1921
Number of pages7
JournalAIDS
Volume21
Issue number14
DOIs
StatePublished - Sep 2007

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Highly Active Antiretroviral Therapy
CD4 Lymphocyte Count
Immunosuppression
Incidence
Acquired Immunodeficiency Syndrome
Clinical Trials
HIV
Immunocompetence
Wounds and Injuries
Disease Progression
Cohort Studies
Demography
Prospective Studies
Therapeutics

Keywords

  • HAART
  • HIV
  • Incidence
  • Neurocognitive impairment
  • Prevalence

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology

Cite this

Robertson, K. R., Smurzynski, M., Parsons, T. D., Wu, K., Bosch, R. J., Wu, J., ... Ellis, R. J. (2007). The prevalence and incidence of neurocognitive impairment in the HAART era. AIDS, 21(14), 1915-1921. https://doi.org/10.1097/QAD.0b013e32828e4e27

The prevalence and incidence of neurocognitive impairment in the HAART era. / Robertson, Kevin R.; Smurzynski, Marlene; Parsons, Thomas D.; Wu, Kunling; Bosch, Ronald J.; Wu, Julia; McArthur, Justin Charles; Collier, Ann C.; Evans, Scott R.; Ellis, Ron J.

In: AIDS, Vol. 21, No. 14, 09.2007, p. 1915-1921.

Research output: Contribution to journalArticle

Robertson, KR, Smurzynski, M, Parsons, TD, Wu, K, Bosch, RJ, Wu, J, McArthur, JC, Collier, AC, Evans, SR & Ellis, RJ 2007, 'The prevalence and incidence of neurocognitive impairment in the HAART era', AIDS, vol. 21, no. 14, pp. 1915-1921. https://doi.org/10.1097/QAD.0b013e32828e4e27
Robertson KR, Smurzynski M, Parsons TD, Wu K, Bosch RJ, Wu J et al. The prevalence and incidence of neurocognitive impairment in the HAART era. AIDS. 2007 Sep;21(14):1915-1921. https://doi.org/10.1097/QAD.0b013e32828e4e27
Robertson, Kevin R. ; Smurzynski, Marlene ; Parsons, Thomas D. ; Wu, Kunling ; Bosch, Ronald J. ; Wu, Julia ; McArthur, Justin Charles ; Collier, Ann C. ; Evans, Scott R. ; Ellis, Ron J. / The prevalence and incidence of neurocognitive impairment in the HAART era. In: AIDS. 2007 ; Vol. 21, No. 14. pp. 1915-1921.
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