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HIV-associated cognitive impairment before and after the advent of combination therapy

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Abstract

The objective of this study was to describe the occurrence of HIV dementia and neuropsychological testing abnormalities in a new cohort of HIV-seropositive individuals at high risk for HIV dementia and to compare these results to a cohort before the advent of highly active antiretroviral therapy (HAART). HAART has been associated with improvements in cognitive performance in some HIV-infected patients. However, it is uncertain whether HAART has changed the frequency of specific neurocognitive abnormalities. Baseline data from 272 HIV-seropositive subjects in the Dana cohort recruited from January, 1994, to December, 1995, and 251 HIV-seropositive subjects in the Northeastern AIDS Dementia Consortium (NEAD) cohort recruited from April, 1998, to August, 1999, were compared. Participants in both cohorts received nearly identical assessments. After adjusting for differences in age, education, gender, race, and CD4 count between the two cohorts, there were no differences in the occurrence of HIV dementia or abnormalities either 1 SD or 2 SDs below established norms for any of the neuropsychological tests. Even though HAART has reduced the incidence of HIV dementia, HIV-associated cognitive impairment continues to be a major clinical problem among individuals with advanced infection.

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Author information

Authors and Affiliations

  1. Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA

    Ned Sacktor, Ola A. Selnes & Justin C. McArthur

  2. Department of Epidemiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA

    Justin C. McArthur

  3. Department of Neurology, University of Rochester Medical Center, Rochester, New York, USA

    Giovanni Schifitto, Donna Palumbo, Karl Kieburtz & Joy A. De Marcaida

  4. Department of Biostatistics, University of Rochester Medical Center, Rochester, New York, USA

    Michael P. McDermott

  5. Department of Neurology, Columbia University, New York, New York

    Karen Marder, Yaakov Stern & Steve Albert

  6. Department of Neurology, Northwestern University Medical School, Chicago, Illinois, USA

    Bruce Cohen & Leon Epstein

  7. Department of Neurology, Johns Hopkins Bayview Medical Center, 4940 Eastern Avenue, B-Building, Room 122, 21224, Baltimore, MD, USA

    Ned Sacktor

Authors
  1. Ned Sacktor
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  2. Michael P. McDermott
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  3. Karen Marder
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  4. Giovanni Schifitto
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  5. Ola A. Selnes
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  6. Justin C. McArthur
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  7. Yaakov Stern
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  8. Steve Albert
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  9. Donna Palumbo
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  10. Karl Kieburtz
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  11. Joy A. De Marcaida
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  12. Bruce Cohen
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  13. Leon Epstein
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Corresponding author

Correspondence to Ned Sacktor.

Additional information

This work was supported by the Charles A. Dana Foundation and by NIH grants NS-36519, NS-26643, NS-36519, RR-00722, RR-00044, and RR-00645.

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Sacktor, N., McDermott, M.P., Marder, K. et al. HIV-associated cognitive impairment before and after the advent of combination therapy. Journal of NeuroVirology 8, 136–142 (2002). https://doi.org/10.1080/13550280290049615

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  • DOI: https://doi.org/10.1080/13550280290049615

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