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Neuropsychological test performance before and after HIV-1 seroconversion: the Multicenter AIDS Cohort Study

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Abstract

The objective of this study is to compare neuropsychological test performance before and after HIV-1 seroconversion in order to identify possible acute changes in psychomotor speed, memory, attention, and concentration secondary to seroconversion. The study utilized mixed effects models to examine longitudinal neuropsychological test data. We conducted a nested cohort study of 362 male HIV-1 seroconverters enrolled in the Multicenter AIDS Cohort Study. We used linear mixed models with random subject effects to compare repeated neuropsychological test outcomes from 5 years before seroconversion to 2 years after seroconversion on the Trail Making Test (parts A and B), Symbol-Digit Test, Grooved Pegboard (dominant and non-dominant hands), Stroop Color-Interference Test, Rey Auditory Verbal Learning Test, and the CalCAP Reaction Time Test. We found no significant changes in the time-dependent score after seroconversion for the majority of neuropsychological tests used in the Multicenter AIDS Cohort Study. There was a significant change in time trend after seroconversion on part B of the Trail Making Test (p = 0.042), but the difference only represented a 2 % decrease in performance. We found the following characteristics to be associated with worse neuropsychological test performance: lower education levels, history of depression, older age, and no previous neurocognitive testing (p < .05). Our results suggest that despite a 50 % decrease in CD4 cell count immediately following infection, HIV-1 does not appear to have a measurable effect on psychomotor or complex cognitive processing for up to 2 years following infection, using this set of neurocognitive measures.

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Acknowledgments

The authors are grateful to the participants and staff of the Multicenter AIDS Cohort Study for their time and dedication. Data in this manuscript were collected by the Multicenter AIDS Cohort Study (MACS) with centers (Principal Investigators) at The Johns Hopkins Bloomberg School of Public Health (Joseph B. Margolick, Lisa P. Jacobson), Howard Brown Health Center, Feinberg School of Medicine, Northwestern University, and Cook County Bureau of Health Services (John P. Phair, Steven M. Wolinsky), University of California, Los Angeles (Roger Detels, Otoniel Martinez-Maza), and University of Pittsburgh (Charles R. Rinaldo). The authors thank Dr. Carolyn F. M. Williams for her review of the manuscript. The MACS is funded by the National Institute of Allergy and Infectious Diseases (Robin E. Huebner, JoanaD’arc Roe) with additional supplemental funding from the National Cancer Institute (Geraldina Dominguez). UO1-AI-35042, UL1-RR025005 (GCRC), UO1-AI-35043, UO1-AI-35039, UO1-AI-35040, UO1-AI-35041. Website located at http://www.statepi.jhsph.edu/macs/macs.html.

Conflict of interest

Dr. Miller is the author of the CalCAP Reaction Time Program and has a financial interest in this software.

Funding sources

Ms. Vo is supported by the National Institute of Allergies and Infectious Diseases, National Institutes of Health, Department of Health and Human Services, under contract no. HHSN272200800014C.

Disclaimer

The views expressed in written conference materials or publications and by speakers and moderators at HHS-sponsored conferences do not necessarily reflect the official policies of the Department of Health and Human Services, nor does mention of trade names, commercial practices, or organizations imply endorsement by the U.S. Government.

Some data from this manuscript have been presented at the Conference on Retroviruses and Opportunistic Infections in March 2012, Seattle, WA.

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Authors and Affiliations

  1. Division of AIDS, The Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA

    Quynh T. Vo

  2. Department of Epidemiology, The Bloomberg School of Public Health, The Johns Hopkins University, Baltimore, MD, USA

    Christopher Cox, Xiuhong Li & Lisa P. Jacobson

  3. Division of AIDS, National Institute of Allergies and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA

    Rosemary McKaig

  4. Department of Neurology, The Johns Hopkins Hospital, Baltimore, MD, USA

    Ned Sacktor & Ola A. Selnes

  5. Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA

    Eileen Martin

  6. Departments of Psychiatry, Neurology and Psychology, University of Pittsburgh, Pittsburgh, PA, USA

    James T. Becker

  7. Semel Institute for Neuroscience, University of California, Los Angeles, CA, USA

    Eric N. Miller

  8. NIAID/DAIDS/BSP Epidemiology Branch, 6700B Rockledge Drive, Room 4218-MSC 7626, Bethesda, MD, 20892-7626, USA

    Quynh T. Vo

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  1. Quynh T. Vo
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Correspondence to Quynh T. Vo.

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Vo, Q.T., Cox, C., Li, X. et al. Neuropsychological test performance before and after HIV-1 seroconversion: the Multicenter AIDS Cohort Study. J. Neurovirol. 19, 24–31 (2013). https://doi.org/10.1007/s13365-012-0136-8

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  • DOI: https://doi.org/10.1007/s13365-012-0136-8

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