Low prevalence of neurocognitive impairment in early diagnosed and managed HIV-infected persons
To describe the prevalence of neurocognitive impairment (NCI) among early diagnosed and managed HIV-infected persons (HIV+) compared to HIV-negative controls. We performed a cross-sectional study among 200 HIV+ and 50 matched HIV-uninfected (HIV-) military beneficiaries. HIV+ patients were categoriz...
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| Veröffentlicht in: | Neurology 2013-01, Vol.80 (4), p.371-379 |
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| creator | CRUM-CIANFLONE, Nancy F MOORE, David J HALE, Braden R LETENDRE, Scott POEHLMAN ROEDIGER, Mollie EBERLY, Lynn WEINTROB, Amy GANESAN, Anuradha JOHNSON, Erica DEL ROSARIO, Raechel AGAN, Brian K |
| description | To describe the prevalence of neurocognitive impairment (NCI) among early diagnosed and managed HIV-infected persons (HIV+) compared to HIV-negative controls.
We performed a cross-sectional study among 200 HIV+ and 50 matched HIV-uninfected (HIV-) military beneficiaries. HIV+ patients were categorized as earlier (200 cells/mm(3)) or later stage patients (n = 100 in each group); both groups were diagnosed early and had access to care. NCI was diagnosed using a comprehensive battery of standardized neuropsychological tests.
HIV+ patients had a median age of 36 years, 91% were seroconverters (median window of 1.2 years), had a median duration of HIV of 5 years, had a CD4 nadir of 319, had current CD4 of 546 cells/mm(3), and 64% were on highly active antiretroviral therapy (initiated 1.3 years after diagnosis at a median CD4 of 333 cells/mm(3)). NCI was diagnosed among 38 (19%, 95% confidence interval 14%-25%) HIV+ patients, with a similar prevalence of NCI among earlier and later stage patients (18% vs 20%, p = 0.72). The prevalence of NCI among HIV+ patients was similar to HIV- patients.
HIV+ patients diagnosed and managed early during the course of HIV infection had a low prevalence of NCI, comparable to matched HIV-uninfected persons. Early recognition and management of HIV infection may be important in limiting neurocognitive impairment. |
| doi_str_mv | 10.1212/WNL.0b013e31827f0776 |
| format | Article |
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We performed a cross-sectional study among 200 HIV+ and 50 matched HIV-uninfected (HIV-) military beneficiaries. HIV+ patients were categorized as earlier (<6 years of HIV, no AIDS-defining conditions, and CD4 nadir >200 cells/mm(3)) or later stage patients (n = 100 in each group); both groups were diagnosed early and had access to care. NCI was diagnosed using a comprehensive battery of standardized neuropsychological tests.
HIV+ patients had a median age of 36 years, 91% were seroconverters (median window of 1.2 years), had a median duration of HIV of 5 years, had a CD4 nadir of 319, had current CD4 of 546 cells/mm(3), and 64% were on highly active antiretroviral therapy (initiated 1.3 years after diagnosis at a median CD4 of 333 cells/mm(3)). NCI was diagnosed among 38 (19%, 95% confidence interval 14%-25%) HIV+ patients, with a similar prevalence of NCI among earlier and later stage patients (18% vs 20%, p = 0.72). The prevalence of NCI among HIV+ patients was similar to HIV- patients.
HIV+ patients diagnosed and managed early during the course of HIV infection had a low prevalence of NCI, comparable to matched HIV-uninfected persons. Early recognition and management of HIV infection may be important in limiting neurocognitive impairment.</description><identifier>ISSN: 0028-3878</identifier><identifier>EISSN: 1526-632X</identifier><identifier>DOI: 10.1212/WNL.0b013e31827f0776</identifier><identifier>PMID: 23303852</identifier><identifier>CODEN: NEURAI</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins</publisher><subject>Adolescent ; Adult ; Age ; AIDS Dementia Complex - diagnosis ; AIDS Dementia Complex - drug therapy ; AIDS Dementia Complex - epidemiology ; Anti-HIV Agents - therapeutic use ; Antiretroviral Therapy, Highly Active - statistics & numerical data ; Biological and medical sciences ; CD4 antigen ; CD4 Lymphocyte Count - statistics & numerical data ; Cognition ; Cognition Disorders - diagnosis ; Cognition Disorders - epidemiology ; Cognition Disorders - virology ; Comorbidity ; Cross-Sectional Studies ; Early Diagnosis ; Female ; highly active antiretroviral therapy ; Human immunodeficiency virus ; Human viral diseases ; Humans ; Infection ; Infectious diseases ; Male ; Medical sciences ; Middle Aged ; Military Personnel - statistics & numerical data ; Neurology ; Neuropsychological Tests ; Prevalence ; Risk Factors ; Viral diseases ; Viral diseases of the lymphoid tissue and the blood. Aids ; Young Adult</subject><ispartof>Neurology, 2013-01, Vol.80 (4), p.371-379</ispartof><rights>2014 INIST-CNRS</rights><rights>2013 American Academy of Neurology 2013 American Academy of Neurology</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c471t-dcb046094b30b905545652a021cff5fbdb8eb43b9708a608daca49a3da0561593</citedby><cites>FETCH-LOGICAL-c471t-dcb046094b30b905545652a021cff5fbdb8eb43b9708a608daca49a3da0561593</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,881,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=27061683$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23303852$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>CRUM-CIANFLONE, Nancy F</creatorcontrib><creatorcontrib>MOORE, David J</creatorcontrib><creatorcontrib>HALE, Braden R</creatorcontrib><creatorcontrib>LETENDRE, Scott</creatorcontrib><creatorcontrib>POEHLMAN ROEDIGER, Mollie</creatorcontrib><creatorcontrib>EBERLY, Lynn</creatorcontrib><creatorcontrib>WEINTROB, Amy</creatorcontrib><creatorcontrib>GANESAN, Anuradha</creatorcontrib><creatorcontrib>JOHNSON, Erica</creatorcontrib><creatorcontrib>DEL ROSARIO, Raechel</creatorcontrib><creatorcontrib>AGAN, Brian K</creatorcontrib><title>Low prevalence of neurocognitive impairment in early diagnosed and managed HIV-infected persons</title><title>Neurology</title><addtitle>Neurology</addtitle><description>To describe the prevalence of neurocognitive impairment (NCI) among early diagnosed and managed HIV-infected persons (HIV+) compared to HIV-negative controls.
We performed a cross-sectional study among 200 HIV+ and 50 matched HIV-uninfected (HIV-) military beneficiaries. HIV+ patients were categorized as earlier (<6 years of HIV, no AIDS-defining conditions, and CD4 nadir >200 cells/mm(3)) or later stage patients (n = 100 in each group); both groups were diagnosed early and had access to care. NCI was diagnosed using a comprehensive battery of standardized neuropsychological tests.
HIV+ patients had a median age of 36 years, 91% were seroconverters (median window of 1.2 years), had a median duration of HIV of 5 years, had a CD4 nadir of 319, had current CD4 of 546 cells/mm(3), and 64% were on highly active antiretroviral therapy (initiated 1.3 years after diagnosis at a median CD4 of 333 cells/mm(3)). NCI was diagnosed among 38 (19%, 95% confidence interval 14%-25%) HIV+ patients, with a similar prevalence of NCI among earlier and later stage patients (18% vs 20%, p = 0.72). The prevalence of NCI among HIV+ patients was similar to HIV- patients.
HIV+ patients diagnosed and managed early during the course of HIV infection had a low prevalence of NCI, comparable to matched HIV-uninfected persons. Early recognition and management of HIV infection may be important in limiting neurocognitive impairment.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Age</subject><subject>AIDS Dementia Complex - diagnosis</subject><subject>AIDS Dementia Complex - drug therapy</subject><subject>AIDS Dementia Complex - epidemiology</subject><subject>Anti-HIV Agents - therapeutic use</subject><subject>Antiretroviral Therapy, Highly Active - statistics & numerical data</subject><subject>Biological and medical sciences</subject><subject>CD4 antigen</subject><subject>CD4 Lymphocyte Count - statistics & numerical data</subject><subject>Cognition</subject><subject>Cognition Disorders - diagnosis</subject><subject>Cognition Disorders - epidemiology</subject><subject>Cognition Disorders - virology</subject><subject>Comorbidity</subject><subject>Cross-Sectional Studies</subject><subject>Early Diagnosis</subject><subject>Female</subject><subject>highly active antiretroviral therapy</subject><subject>Human immunodeficiency virus</subject><subject>Human viral diseases</subject><subject>Humans</subject><subject>Infection</subject><subject>Infectious diseases</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Military Personnel - statistics & numerical data</subject><subject>Neurology</subject><subject>Neuropsychological Tests</subject><subject>Prevalence</subject><subject>Risk Factors</subject><subject>Viral diseases</subject><subject>Viral diseases of the lymphoid tissue and the blood. Aids</subject><subject>Young Adult</subject><issn>0028-3878</issn><issn>1526-632X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkUtv1TAQhS0EoreFf4BQNkhsUsbPOBskVEFb6Qo2vHbWxLEvRokd7NyL-u8x6qU8NqxmRvPN0RkdQp5QOKeMshef3m7PYQDKHaeadR66Tt0jGyqZahVnn--TDQDTLdedPiGnpXwFqMuuf0hOGOfAtWQbYrbpe7Nkd8DJReua5Jvo9jnZtIthDQfXhHnBkGcX1ybExmGebpox4C6m4sYG49jMGHFX-6vrj22I3tm1DovLJcXyiDzwOBX3-FjPyIc3r99fXLXbd5fXF6-2rRUdXdvRDiAU9GLgMPQgpZBKMgRGrffSD-Og3SD40HegUYEe0aLokY8IUlHZ8zPy8lZ32Q-zG221m3EySw4z5huTMJi_NzF8Mbt0MFzqnglWBZ4fBXL6tndlNXMo1k0TRpf2xVBOJeXVmP4_ynqqqKBSVlTcojanUrLzd44omJ8xmhqj-TfGevb0z2_ujn7lVoFnRwCLxclnjDaU31wHiirN-Q9Tuqf7</recordid><startdate>20130122</startdate><enddate>20130122</enddate><creator>CRUM-CIANFLONE, Nancy F</creator><creator>MOORE, David J</creator><creator>HALE, Braden R</creator><creator>LETENDRE, Scott</creator><creator>POEHLMAN ROEDIGER, Mollie</creator><creator>EBERLY, Lynn</creator><creator>WEINTROB, Amy</creator><creator>GANESAN, Anuradha</creator><creator>JOHNSON, Erica</creator><creator>DEL ROSARIO, Raechel</creator><creator>AGAN, Brian K</creator><general>Lippincott Williams & Wilkins</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20130122</creationdate><title>Low prevalence of neurocognitive impairment in early diagnosed and managed HIV-infected persons</title><author>CRUM-CIANFLONE, Nancy F ; MOORE, David J ; HALE, Braden R ; LETENDRE, Scott ; POEHLMAN ROEDIGER, Mollie ; EBERLY, Lynn ; WEINTROB, Amy ; GANESAN, Anuradha ; JOHNSON, Erica ; DEL ROSARIO, Raechel ; AGAN, Brian K</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c471t-dcb046094b30b905545652a021cff5fbdb8eb43b9708a608daca49a3da0561593</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Age</topic><topic>AIDS Dementia Complex - diagnosis</topic><topic>AIDS Dementia Complex - drug therapy</topic><topic>AIDS Dementia Complex - epidemiology</topic><topic>Anti-HIV Agents - therapeutic use</topic><topic>Antiretroviral Therapy, Highly Active - statistics & numerical data</topic><topic>Biological and medical sciences</topic><topic>CD4 antigen</topic><topic>CD4 Lymphocyte Count - statistics & numerical data</topic><topic>Cognition</topic><topic>Cognition Disorders - diagnosis</topic><topic>Cognition Disorders - epidemiology</topic><topic>Cognition Disorders - virology</topic><topic>Comorbidity</topic><topic>Cross-Sectional Studies</topic><topic>Early Diagnosis</topic><topic>Female</topic><topic>highly active antiretroviral therapy</topic><topic>Human immunodeficiency virus</topic><topic>Human viral diseases</topic><topic>Humans</topic><topic>Infection</topic><topic>Infectious diseases</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Military Personnel - statistics & numerical data</topic><topic>Neurology</topic><topic>Neuropsychological Tests</topic><topic>Prevalence</topic><topic>Risk Factors</topic><topic>Viral diseases</topic><topic>Viral diseases of the lymphoid tissue and the blood. Aids</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>CRUM-CIANFLONE, Nancy F</creatorcontrib><creatorcontrib>MOORE, David J</creatorcontrib><creatorcontrib>HALE, Braden R</creatorcontrib><creatorcontrib>LETENDRE, Scott</creatorcontrib><creatorcontrib>POEHLMAN ROEDIGER, Mollie</creatorcontrib><creatorcontrib>EBERLY, Lynn</creatorcontrib><creatorcontrib>WEINTROB, Amy</creatorcontrib><creatorcontrib>GANESAN, Anuradha</creatorcontrib><creatorcontrib>JOHNSON, Erica</creatorcontrib><creatorcontrib>DEL ROSARIO, Raechel</creatorcontrib><creatorcontrib>AGAN, Brian K</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Neurology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>CRUM-CIANFLONE, Nancy F</au><au>MOORE, David J</au><au>HALE, Braden R</au><au>LETENDRE, Scott</au><au>POEHLMAN ROEDIGER, Mollie</au><au>EBERLY, Lynn</au><au>WEINTROB, Amy</au><au>GANESAN, Anuradha</au><au>JOHNSON, Erica</au><au>DEL ROSARIO, Raechel</au><au>AGAN, Brian K</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Low prevalence of neurocognitive impairment in early diagnosed and managed HIV-infected persons</atitle><jtitle>Neurology</jtitle><addtitle>Neurology</addtitle><date>2013-01-22</date><risdate>2013</risdate><volume>80</volume><issue>4</issue><spage>371</spage><epage>379</epage><pages>371-379</pages><issn>0028-3878</issn><eissn>1526-632X</eissn><coden>NEURAI</coden><abstract>To describe the prevalence of neurocognitive impairment (NCI) among early diagnosed and managed HIV-infected persons (HIV+) compared to HIV-negative controls.
We performed a cross-sectional study among 200 HIV+ and 50 matched HIV-uninfected (HIV-) military beneficiaries. HIV+ patients were categorized as earlier (<6 years of HIV, no AIDS-defining conditions, and CD4 nadir >200 cells/mm(3)) or later stage patients (n = 100 in each group); both groups were diagnosed early and had access to care. NCI was diagnosed using a comprehensive battery of standardized neuropsychological tests.
HIV+ patients had a median age of 36 years, 91% were seroconverters (median window of 1.2 years), had a median duration of HIV of 5 years, had a CD4 nadir of 319, had current CD4 of 546 cells/mm(3), and 64% were on highly active antiretroviral therapy (initiated 1.3 years after diagnosis at a median CD4 of 333 cells/mm(3)). NCI was diagnosed among 38 (19%, 95% confidence interval 14%-25%) HIV+ patients, with a similar prevalence of NCI among earlier and later stage patients (18% vs 20%, p = 0.72). The prevalence of NCI among HIV+ patients was similar to HIV- patients.
HIV+ patients diagnosed and managed early during the course of HIV infection had a low prevalence of NCI, comparable to matched HIV-uninfected persons. Early recognition and management of HIV infection may be important in limiting neurocognitive impairment.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins</pub><pmid>23303852</pmid><doi>10.1212/WNL.0b013e31827f0776</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Neurology, 2013-01, Vol.80 (4), p.371-379 |
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| subjects | Adolescent Adult Age AIDS Dementia Complex - diagnosis AIDS Dementia Complex - drug therapy AIDS Dementia Complex - epidemiology Anti-HIV Agents - therapeutic use Antiretroviral Therapy, Highly Active - statistics & numerical data Biological and medical sciences CD4 antigen CD4 Lymphocyte Count - statistics & numerical data Cognition Cognition Disorders - diagnosis Cognition Disorders - epidemiology Cognition Disorders - virology Comorbidity Cross-Sectional Studies Early Diagnosis Female highly active antiretroviral therapy Human immunodeficiency virus Human viral diseases Humans Infection Infectious diseases Male Medical sciences Middle Aged Military Personnel - statistics & numerical data Neurology Neuropsychological Tests Prevalence Risk Factors Viral diseases Viral diseases of the lymphoid tissue and the blood. Aids Young Adult |
| title | Low prevalence of neurocognitive impairment in early diagnosed and managed HIV-infected persons |
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