Dal Pan G J, Farzadegan H, Selnes O, Hoover D R, Miller E N, Skolasky R L, Nance-Sproson T E, McArthur J C
Department of Neurology, Johns Hopkins University, Baltimore, Maryland, USA.
J Neurovirol. 1998 Feb;4(1):95-9. doi: 10.3109/13550289809113486.
To determine the clinical and virological correlates of neuropsychological test performance decline in HIV infection, we measured viral burden in blood in 272 HIV-seropositive men without dementia in the Baltimore arm of the Multicenter AIDS Cohort Study (MACS). These measures were then related to neuropsychological (NP) decline, defined as a decline relative to prior best performance of 2.0 standard deviations or more on one or more neuropsychological tests. A short battery of NP tests (Mini-Screen Battery) was administered to all 272 men. NP test performance decline was identified in 53/272 (19.5%) of participants on the Mini-Screen Battery. Follow-up NP data were available for 204 participants who had undergone the Mini-Screen. The frequency of sustained NP test performance decline was 7.8% for the Mini-Screen Battery. A lower CD4+ cell count was weakly associated with sustained NP test performance decline. After adjustment for CD4+ cell count, hemoglobin, body mass index, and presence of AIDS, none of the viral burden measures (p24 antigenemia, plasma viremia, quantitative culture) correlated with sustained NP test performance decline. We conclude that these measures of blood HIV viral burden are not markers for NP decline, but that a lower CD4+ cell count is.
为了确定HIV感染中神经心理测试表现下降的临床和病毒学相关因素，我们在多中心艾滋病队列研究（MACS）的巴尔的摩分部对272名无痴呆的HIV血清阳性男性进行了血液病毒载量测量。然后将这些测量结果与神经心理（NP）下降相关联，NP下降定义为在一项或多项神经心理测试中相对于先前最佳表现下降2.0个标准差或更多。对所有272名男性进行了一组简短的NP测试（迷你筛查组）。在迷你筛查组的53/272（19.5%）参与者中发现了NP测试表现下降。有204名接受迷你筛查的参与者可获得后续NP数据。迷你筛查组持续NP测试表现下降的频率为7.8%。较低的CD4+细胞计数与持续NP测试表现下降弱相关。在对CD4+细胞计数、血红蛋白、体重指数和艾滋病状况进行调整后，病毒载量测量指标（p24抗原血症、血浆病毒血症、定量培养）均与持续NP测试表现下降无关。我们得出结论，这些血液HIV病毒载量测量指标不是NP下降的标志物，而较低的CD4+细胞计数是。
