a Department of Psychiatry , University of Illinois at Chicago , Chicago , IL , USA.
J Clin Exp Neuropsychol. 2013;35(9):915-25. doi: 10.1080/13803395.2013.838939. Epub 2013 Oct 1.
Treatment with combination antiretroviral therapy (cART) regimens with a high capacity to penetrate the blood-brain barrier has been associated with lower levels of human immunodeficiency virus (HIV) in the central nervous system (CNS). This study examined neurocognitive performance among a sample of 118 HIV+ substance-dependent individuals (SDIs) and 310 HIV- SDIs. HIV+ participants were prescribed cART regimens with varying capacity to penetrate the CNS as indexed by the revised CNS Penetration Effectiveness (CPE) scale. Participants completed the Rotary Pursuit Task (RPT) and the Weather Prediction Task (WPT)-two measures of procedural learning (PL) with known sensitivity to HIV infection-and a control task of sustained attention. HIV+ SDIs prescribed cART with relatively high CNS penetrance performed significantly more poorly on both tasks than HIV- controls. Task performance of HIV+ SDIs prescribed cART with relatively low CNS penetrance did not differ significantly from either HIV- controls or the HIV+/high CPE group, although a trend toward lower RPT performance than that of HIV- participants was observed. Between-group differences were not seen on a control task of motor impulsivity (Immediate Memory Task), indicating that the observed deficits among HIV+/high CPE SDIs may have some specificity.
联合抗逆转录病毒疗法（cART）方案治疗具有较高的血脑屏障穿透能力，与中枢神经系统（CNS）中人类免疫缺陷病毒（HIV）水平较低相关。本研究检查了 118 名 HIV 阳性物质依赖个体（SDI）和 310 名 HIV 阴性 SDI 样本的神经认知表现。HIV 阳性参与者接受了不同 CNS 穿透能力的 cART 方案治疗，以修订后的 CNS 穿透效能（CPE）量表为指标。参与者完成了旋转追踪任务（RPT）和天气预测任务（WPT）——这两个程序学习（PL）的衡量标准，对 HIV 感染具有已知的敏感性——以及持续注意力的控制任务。与 HIV-对照组相比，接受具有相对较高 CNS 穿透能力的 cART 方案治疗的 HIV+ SDI 在这两项任务中的表现明显更差。接受相对较低 CNS 穿透能力的 cART 方案治疗的 HIV+ SDI 的任务表现与 HIV-对照组或 HIV+/高 CPE 组没有显著差异，尽管观察到与 HIV-参与者相比，RPT 表现略低的趋势。在运动冲动性（即时记忆任务）的控制任务中没有观察到组间差异，表明 HIV+/高 CPE SDI 中观察到的缺陷可能具有一定的特异性。
