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Neurocognitive functioning in a Romanian cohort of young adults with parenterally-acquired HIV-infection during childhood

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Abstract

The Romanian cohort can provide valuable information about the effect of chronic HIV-infection and exposure to combined antiretroviral therapy (cART) on the developing brain, based on its unique characteristics: young adults infected parenterally with HIV clade F in the late 1980s and exposed to cART for a decade. We conducted a prospective study using a neuropsychological test battery validated in other international HIV cohorts, in order to evaluate the rate and severity of neurocognitive impairment in a group of young Romanian adults. The 49 HIV-infected (HIV+) participants and the 20 HIV negative (HIV−) controls were similar for age and gender, although the HIV− group tended to be more educated. We found higher cognitive impairment prevalence in the HIV+ group (59.1 %) versus the HIV− group (10 %), and the impairment rate remained significantly higher even when the groups were matched based on the educational level (38.7 % for the HIV+ group vs. 10.0 % for the HIV− controls; p = 0.025). The nadir CD4 count was <200 in 71.4 % of patients, but at the time of neurocognitive assessment, 89.5 % of patients had normal immunological status and 81.8 % undetectable HIV load. Among the HIV-impaired group, 26 % of the participants had syndromic impairment while the other 74 % had asymptomatic neurocognitive impairment. We found a high prevalence of neurocognitive dysfunction in the Romanian young adults growing-up with HIV. The greatest HIV-related cognitive deficits were in the domains of executive and motor functioning, consistent with a frontosubcortical pattern.

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Acknowledgments

The authors would like to thank all participants in the study; Gratiela Tardei, MD for the laboratory assessments for the study participants, and Maiko Sakamoto, PhD for background literature review and editorial comments on the manuscript. This work was supported by an R21 MH077487-01 NIMH grant and the HIV Neurobehavioral Research Center at UCSD (P30MH062512).

Conflict of interest

The authors declare that they have no competing interests.

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Authors and Affiliations

  1. HIV Department, “Dr. Victor Babes” Hospital for Infectious and Tropical Diseases, 281, sos. Mihai Bravu, 030303, Bucharest, Romania

    Luminita Ene, Ruxandra Burlacu, Anca E. Luca, Andreea G. Blaglosov & Dan C. Duiculescu

  2. HIV Neurobehavioral Research Program, University of California, San Diego, CA, USA

    Donald R. Franklin, Ronald J. Ellis, Terry J. Alexander, Anya Umlauf, Igor Grant, Cristian L. Achim & Thomas D. Marcotte

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  1. Luminita Ene
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  2. Donald R. Franklin
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  3. Ruxandra Burlacu
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  4. Anca E. Luca
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  5. Andreea G. Blaglosov
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  10. Dan C. Duiculescu
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Ene, L., Franklin, D.R., Burlacu, R. et al. Neurocognitive functioning in a Romanian cohort of young adults with parenterally-acquired HIV-infection during childhood. J. Neurovirol. 20, 496–504 (2014). https://doi.org/10.1007/s13365-014-0275-1

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