Effects of highly active antiretroviral therapy on cognitive functions in severely immune-compromised HIV-seropositive patients

J Neurol Sci. 2012 Feb 15;313(1-2):115-22. doi: 10.1016/j.jns.2011.09.011. Epub 2011 Oct 11.

Abstract

Objective: This study assessed the effects of highly active antiretroviral therapy on the cognitive performances of HIV seropositive patients with severe immune depression.

Methods: It is a prospective longitudinal interventional study of 69 anti-retroviral naïve HIV-seropositive adult patients with CD4 levels ≤ 350/μl. The cognitive assessment was done at initiation and 12 months after anti-retroviral treatment using the Community Screening Instrument for Dementia (CSID) and the computer-assisted Iron Psychology (FePsy). The impact of therapy on CD4 levels and cognitive scores of the patients before and after therapy were compared and tested for statistical significance using Student t test and one-way ANOVA.

Results: The mean age of the patients was 36.6 ± 8.8 years. There was a significant increase in CD4 levels of the patients from 144.75 ± 88.92 at baseline to 295.91 ± 148.79 after 12 months of HAART (p<0.0001). There were significant improvements in their cognitive scores (p<0.05) in all cognitive domains tested but the finger tapping task (motor speed) did not show any improvement (p>0.05). Combination ARV drugs with efavirenz did not significantly improve attention and choice reaction time.

Conclusion: Highly active antiretroviral therapy significantly improved the CD4 levels and cognitive performances of treated HIV positive patients in all tested domains with the exception of motor speed.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Antiretroviral Therapy, Highly Active / methods*
  • Cognition / drug effects*
  • Cognition / physiology
  • Female
  • HIV Seropositivity / drug therapy*
  • HIV Seropositivity / immunology
  • HIV Seropositivity / psychology
  • Humans
  • Immunocompromised Host / drug effects*
  • Immunocompromised Host / physiology
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Prospective Studies
  • Severity of Illness Index*
  • Treatment Outcome
  • Young Adult