Neuropsychological impairment and the natural history of HIV-1 infection in Spanish subjects

The authors set out to determine the rates and pattern of neuropsychological impairment shown by seropositive Spanish patients in different stages of HIV infection. A clinical sample was recruited consisting of 115 heterosexual subjects (30 seropositive asymptomatic; 17 seropositive in stage B; 41 seropositive with AIDS, and 27 seronegative). All subjects provided written informed consent and were submitted to the same process of evaluation. A rate of neuropsychological impairment of 33.3% was found in stage A (asymptomatic patients); of 41.2% in stage B (low symptomatology patients); and of 70.7% in stage C (AIDS patients). The pattern of neuropsychological impairment shown by the AIDS patients was qualitatively similar to that observed in the asymptomatic subjects, and consistent with fronto-subcortical-type alterations. Clinically asymptomatic HIV infection represents a risk factor for neuropsychological impairment, even though our results reinforce the idea that the impairment seen in the asymptomatic stages cannot be interpreted as a predictor of more severe cognitive deficits as the disease progresses.