Odiase Francis E, Ogunrin Olubunmi A, Ogunniyi Adesola A
Neurology Unit, Department of Medicine, University of Benin Teaching Hospital, Benin City, Nigeria.
Can J Neurol Sci. 2007 May;34(2):154-9. doi: 10.1017/s0317167100005977.
Memory impairment, usually impaired retrieval of information, has been described in HIV/AIDS, especially among those with severe illness. Neuro-cognitive disturbances in HIV/AIDS have been linked to poor quality of life and medication adherence. This prospective, case-control study was designed to assess the verbal and non-verbal memory as well as the attention abilities of Nigerian Africans with HIV/AIDS and correlate their performances with their CD4+ T lymphocytes (CD4+) counts.
A total of 288 randomly selected subjects, comprising 96 HIV-positive symptomatic patients, 96 HIV-positive asymptomatic patients and 96 HIV-negative controls, participated in the study. The subjects were age-, sex-, and level of education matched. The Recognition Memory Test and Choice Reaction Time tasks, components of the computer-assisted neuropsychological tests battery- the Iron Psychology 'FePsy' were used for cognitive assessments.
The mean memory scores of the HIV-positive asymptomatic subjects did not differ significantly from the controls (p > 0.05) but the HIV-positive symptomatic subjects' scores were significantly lower than the controls (p < 0.05). Both HIV-positive groups had psychomotor slowing and impaired attention (p < 0.05). The HIV-positive subjects with CD4+ counts < 200/microl and between 200 and 499/microl had significant memory impairment (p < 0.001 and p < 0.001 respectively) but there was no significant impairment among those with count > or = 500/microl. Impaired ability for sustained attention was however present irrespective of the CD4+ level relative to controls (p < 0.001).
We concluded that there was no significant memory disturbance among HIV-positive asymptomatic subjects despite the presence of impaired attention and psychomotor slowing, and that the severity of immune suppression (as indicated by the CD4+ T lymphocytes count) is a strong determinant of cognitive decline in HIV/AIDS.
记忆障碍，通常是信息提取受损，在艾滋病毒/艾滋病患者中已有描述，尤其是在重症患者中。艾滋病毒/艾滋病患者的神经认知障碍与生活质量差和药物依从性有关。这项前瞻性病例对照研究旨在评估尼日利亚非洲艾滋病毒/艾滋病患者的言语和非言语记忆以及注意力能力，并将他们的表现与其CD4 + T淋巴细胞（CD4 +）计数相关联。
共有288名随机选择的受试者参与了该研究，其中包括96名艾滋病毒阳性有症状患者、96名艾滋病毒阳性无症状患者和96名艾滋病毒阴性对照者。受试者在年龄、性别和教育水平上相匹配。使用计算机辅助神经心理测试电池——Iron Psychology 'FePsy' 的组成部分识别记忆测试和选择反应时任务进行认知评估。
艾滋病毒阳性无症状受试者的平均记忆得分与对照组无显著差异（p>0.05），但艾滋病毒阳性有症状受试者的得分显著低于对照组（p<0.05）。两个艾滋病毒阳性组均存在精神运动迟缓且注意力受损（p<0.05）。CD4 +计数<200/微升和200至499/微升的艾滋病毒阳性受试者存在显著记忆障碍（分别为p<0.001和p<0.001），但计数>或=500/微升的受试者中无显著障碍。然而，与对照组相比，无论CD4 +水平如何，持续注意力能力均受损（p<0.001）。
我们得出结论，尽管存在注意力受损和精神运动迟缓，但艾滋病毒阳性无症状受试者中无显著记忆障碍，并且免疫抑制的严重程度（由CD4 + T淋巴细胞计数表示）是艾滋病毒/艾滋病认知衰退的一个重要决定因素。
