Department of Mental Health and Social Psychology, National Institute of Mental Health and Neurosciences, Bangalore, India.
J Neurovirol. 2008 Nov;14(6):480-5. doi: 10.1080/13550280802304746.
Asymptomatic human immunodeficiency virus (HIV) infection is associated with impaired cognitive functioning in both clade B and C infections. The nature of cognitive change longitudinally has not been studied in asymptomatic clade C infection. The present study evaluated changes in neuropsychological functioning over a 2(1/2)-year period in a cohort of HIV-1 clade C-infected asymptomatic individuals from South India. Participants with CD4 counts below 250 were started on highly active antiretroviral therapy (HAART) as per National AIDS Control Organisation NACO guidelines and hence excluded. The sample consisted of 68 patients (30 men and 38 women), with a mean age of 29.4 years (SD=5.6 years) and a mean education of 10.0 years (SD=2.7 years). A comprehensive neuropsychological assessment with 12 tests yielding 21 variables was used to examine cognitive functioning at baseline and subsequently at 6-monthly intervals for five follow-ups. Shift in CD4 and viral load categories measured by the McNemar's test indicated disease progression. Latent growth curve (LGC) modeling assessed the nature of change in cognition over the 2(1/2)-year study period. Ten variables representing attention, executive functions, and long-term memory fit the LGC model. Excepting visual working memory, the slope was nonsignificant for nine variables, indicating absence of deterioration in cognition over a 2(1/2)-year period. However, CD4 and viral load levels worsened, indicating disease progression. Asymptomatic individuals with HIV-1 clade C infection do not show any significant decline on individual neuropsychological functions over 2(1/2) years despite disease progression, as evidenced by immune suppression and viral loads.
无症状人类免疫缺陷病毒 (HIV) 感染与 clade B 和 C 感染中的认知功能障碍有关。无症状 clade C 感染中，认知变化的性质尚未进行纵向研究。本研究评估了来自印度南部的 HIV-1 clade C 感染无症状个体队列中，2 年半期间神经心理功能的变化。根据国家艾滋病控制组织 NACO 指南，CD4 计数低于 250 的参与者开始接受高效抗逆转录病毒治疗 (HAART)，因此被排除在外。样本包括 68 名患者（30 名男性和 38 名女性），平均年龄为 29.4 岁（SD=5.6 岁），平均受教育程度为 10.0 年（SD=2.7 年）。使用包含 12 个测试的综合神经心理学评估，得出 21 个变量，用于在基线和随后的 5 次随访中每 6 个月检查认知功能。用 McNemar 检验衡量的 CD4 和病毒载量类别变化表明疾病进展。潜在增长曲线 (LGC) 模型评估了认知在 2 年半研究期间的变化性质。10 个变量代表注意力、执行功能和长期记忆，符合 LGC 模型。除了视觉工作记忆外，九个变量的斜率无统计学意义，表明认知在 2 年半期间没有恶化。然而，CD4 和病毒载量水平恶化，表明疾病进展。尽管免疫抑制和病毒载量表明疾病进展，但 HIV-1 clade C 感染的无症状个体在 2 年半时间内，个别神经心理功能没有出现任何明显下降。
