Neurocognitive functioning in acute or early HIV infection.

TitleNeurocognitive functioning in acute or early HIV infection.
Publication TypeJournal Article
Year of Publication2011
AuthorsMoore, DJ, Letendre, SL, Morris, S, Umlauf, A, Deutsch, R, Smith, DM, Little, S, Rooney, A, Franklin, DR, Gouaux, B, Leblanc, S, Rosario, D, Fennema-Notestine, C, Heaton, RK, Ellis, RJ, J Atkinson, H, Grant, I
Corporate AuthorsCHARTER Group
JournalJ Neurovirol
Date Published2011 Feb
KeywordsAdult, CHARTER, Cognition Disorders, Female, HIV Infections, HIV Seronegativity, Humans, Internal, Linear Models, Logistic Models, Male, Multivariate Analysis, Neuropsychological Tests, Substance-Related Disorders, Viral Load, Young Adult

We examined neurocognitive functioning among persons with acute or early HIV infection (AEH) and hypothesized that the neurocognitive performance of AEH individuals would be intermediate between HIV seronegatives (HIV-) and those with chronic HIV infection. Comprehensive neurocognitive testing was accomplished with 39 AEH, 63 chronically HIV infected, and 38 HIV- participants. All AEH participants were HIV infected for less than 1 year. Average domain deficit scores were calculated in seven neurocognitive domains. HIV-, AEH, and chronically HIV infected groups were ranked from best (rank of 1) to worst (rank of 3) in each domain. All participants received detailed substance use, neuromedical, and psychiatric evaluations and HIV infected persons provided information on antiretroviral treatment and completed laboratory evaluations including plasma and CSF viral loads. A nonparametric test of ordered alternatives (Page test), and the appropriate nonparametric follow-up test, was used to evaluate level of neuropsychological (NP) functioning across and between groups. The median duration of infection for the AEH group was 16 weeks [interquartile range, IQR: 10.3-40.7] as compared to 4.9 years [2.8-11.1] in the chronic HIV group. A Page test using ranks of average scores in the seven neurocognitive domains showed a significant monotonic trend with the best neurocognitive functioning in the HIV- group (mean rank = 1.43), intermediate neurocognitive functioning in the AEH group (mean rank = 1.71), and the worst in the chronically HIV infected (mean rank = 2.86; L statistic = 94, p < 0.01); however, post-hoc testing comparing neurocognitive impairment of each group against each of the other groups showed that the chronically infected group was significantly different from both the HIV- and AEH groups on neurocognitive performance; the AEH group was statistically indistinguishable from the HIV- group. Regression models among HIV infected participants were unable to identify significant predictors of neurocognitive performance. Neurocognitive functioning was worst among persons with chronic HIV infection. Although a significant monotonic trend existed and patterns of the data suggest the AEH individuals may fall intermediate to HIV- and chronic participants, we were not able to statistically confirm this hypothesis.

Alternate JournalJ. Neurovirol.
PubMed ID21165782
PubMed Central IDPMC3032208
Grant ListP01DA012065 / DA / NIDA NIH HHS / United States
AI074621 / AI / NIAID NIH HHS / United States
MH083552 / MH / NIMH NIH HHS / United States
P30 MH062512 / MH / NIMH NIH HHS / United States
P01 DA012065 / DA / NIDA NIH HHS / United States
MH 62512 / MH / NIMH NIH HHS / United States
N01 MH022005 / MH / NIMH NIH HHS / United States
R01 MH083552 / MH / NIMH NIH HHS / United States
P01 AI074621 / AI / NIAID NIH HHS / United States
R24 AI106039 / AI / NIAID NIH HHS / United States