Ghate Manisha, Mehendale Sanjay, Meyer Rachel, Umlauf Anya, Deutsch Reena, Kamat Rujvi, Thakar Madhuri, Risbud Arun, Kulkarni Smita, Sakamoto Maiko, Alexander Terry, Franklin Donald, Letendre Scott, Heaton Robert K, Grant Igor, Marcotte Thomas D
National AIDS Research Institute, Post Box 1895, G-73, MIDC, Bhosari, Pune, Maharashtra, 411026, India,
J Neurovirol. 2015 Aug;21(4):391-8. doi: 10.1007/s13365-015-0329-z. Epub 2015 Mar 7.
There has been a reduction in the most severe cases of HIV-associated neurocognitive disorders (HAND) with advances in antiretroviral treatment (ART). But the prevalence of milder forms of HAND still remains high. Data from systematically conducted studies on the effects of ART on cognition are scanty in India, where HIV-1 clade C is prevalent. The purpose of the present study was to assess the effect of antiretroviral therapy in HIV-seropositive (HIV+) individuals (n = 92) with CD4 cell counts <200 cells/mm(3). The overall and domain-specific levels of cognitive functioning were determined using a locally recruited normative sample, and a change in neurocognitive functioning at the 1-year follow-up visit was analyzed. Results revealed cognitive impairment in 44.6 % of the HIV+ group at baseline. At the 1-year follow-up, the group showed significant improvement in the Learning domain (p < 0.05). HIV+ individuals showing improvement in the global cognitive scores had a significantly lower baseline CD4 cell count compared to others. Overall, the degree of improvement associated with the magnitude of rise in CD4 suggests the possibility that early, mild subclinical deficits may also benefit from treatment.
随着抗逆转录病毒治疗（ART）的进展，与HIV相关的神经认知障碍（HAND）最严重病例有所减少。但较轻形式的HAND患病率仍然很高。在HIV-1 C亚型流行的印度，关于ART对认知影响的系统性研究数据很少。本研究的目的是评估抗逆转录病毒疗法对CD4细胞计数<200个细胞/mm³的HIV血清阳性（HIV+）个体（n = 92）的影响。使用当地招募的正常样本确定认知功能的总体和特定领域水平，并分析1年随访时神经认知功能的变化。结果显示，基线时HIV+组中有44.6%存在认知障碍。在1年随访时，该组在学习领域有显著改善（p < 0.05）。与其他个体相比，全球认知评分有所改善的HIV+个体基线CD4细胞计数显著更低。总体而言，与CD4升高幅度相关的改善程度表明，早期轻度亚临床缺陷也可能从治疗中获益。
