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Neuropsychological performance in symptomatic and asymptomatic HIV infection
R A Bornstein1, H A Nasrallah, M F Para
1Department of Psychiatry, Ohio State University, Columbus.
Objective:
To examine cognitive function in patients at various stages of HIV infection, and to determine the nature and severity associated with stage of illness.
Design:
Subjects were administered an extensive battery of neuropsychological tests.
Subjects:
Two hundred and thirty-three HIV-1-infected homosexual/bisexual men and 77 HIV-negative control subjects who had been screened for previous neurological illness. All subjects were volunteers in a longitudinal study of neurobehavioral complications of HIV infection.
Results:
Patients with symptomatic infection differed from controls on a large number of measures, and asymptomatic patients had a more circumscribed pattern of deficit. On a summary measure of cognitive impairment, there was a twofold increase in the prevalence of impairment in asymptomatic patients relative to controls, and a fourfold increase in symptomatic patients. Memory and dexterity problems appear to be early features of neurobehavioral dysfunction, and frontal lobe deficits were found in patients with symptomatic infection.
Conclusion:
These data indicate that there is a steady increase in the prevalence of neurobehavioral abnormalities associated with stage of infection. The pattern of abnormality also varies with disease stage.