Effects of HIV Seropositivity and Drug Abuse on Cognitive Function

Grassi, Maria Pia; Perin, C; Clerici, Francesca; Zocchetti, Carlo; Borella, M; Cargnel, Antonietta; Mangoni, A

doi:10.1159/000117405

Cited by 18 publications

(7 citation statements)

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“…(13) The prevalence of neurologic complications of AIDS in patients admitted to hospital due to this disease was of the order of 40%, similar to reports in the literature from the mid 1980s onwards. (9,14,15) The percentage of AIDS patients seeking care due to a specific neurologic complaint in our study was 15.7%, while a further 5.1% sought care for a neurologic complaint plus other clinical symptoms.…”

Section: Discussionsupporting

confidence: 85%

Neurologic manifestations of AIDS: a review of fifty cases in Santos

Fragoso¹,

Mendes²,

Adamo³

et al. 1998

Sao Paulo Med. J.

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Objective: To review the neurologic manifestations of AIDS in patients who were admitted to Hospital Guilherme Álvaro (HGA) due to any clinical manifestation of the disease. Design: Case series. Patients: All HIV+ patients admitted to the Faculty Hospital (HGA) between July 96 and April 97 were included in this review. Results: From the 117 HIV+ patients admitted to hospitalization due to AIDS-related symptoms, 50 (42.7%) presented neurologic manifestations. The most prevalent of these was neurotoxoplamosis (68%), but a variety of other neurologic diseases were observed. Only 36% of these 50 patients had neurological signs and symptoms as the main complaint for admission, 12% of the patients had at least complained of some neurologic dysfunction at the time of admission and 10% had no neurologic complaints at all. The remaining 42% (21 patients) only complained of neurologic manifestations of AIDS when specifically asked. Conclusions: The prevalence of neurologic manifestations of AIDS is very high in patients admitted to hospital. Even in the absence of neurologic-related complaints, these patients have to be carefully questioned and examined in the search for an underlying neurologic complication which may present high morbidity and mortality.

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Section: Discussionsupporting

confidence: 85%

Neurologic manifestations of AIDS: a review of fifty cases in Santos

Fragoso¹,

Mendes²,

Adamo³

et al. 1998

Sao Paulo Med. J.

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“…Besides, even if the results of Corsi Test and Block Design reached low significance, they showed a tendency towards an involvement of subcortical functions, that was more stressed by the result of Digit Symbol. These data, as stated by the results of Zung Scale, were not influenced by depression, a possible confounding factor that can be also excluded in the advanced stages of the disease, as already shown, and currently supported in a previous work [15]. Thus CD4 count is more closely associated with cognitive performance than disease stage.…”

Section: Discussionsupporting

confidence: 86%

Assessment of Cognitive Function in Asymptomatic HIV-Positive Subjects

Grassi

Perin²,

Borella³

et al. 1999

Eur Neurol

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This retrospective study aims to assess cognitive involvement in pre-AIDS, not drug abuser subjects and to determine whether CD4 status or disease stage best correlates with cognitive changes that may portend development of ADC. 328 cases were analyzed. No differences in psychometric performance in relation to CDC stage were found. Instead, patients with CD4 < 200/μl performed worse overall, with a statistically significant difference for Digit Symbol, Corsi Test, Block Design and HIVDA Scale. Even if cognitive decline is not evident in the early phase of HIV infection, CD4 count seems the more sensitive early indicator of cognitive changes adequately pointed out by the HIVDA Scale, which could be considered a useful screening tool for cognitive deficit.

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“…It should be noted, however, studies that show increased cognitive impairment in HIV-infected drug abusers (e.g., Grassi et al, 1997) are in stark contrast to studies that show no difference in HAD incidence between drug abusers and non-abusers (e.g., Selnes et al, 1997). Jernigan et al (2005) recently demonstrated no differences in brain volume between HIV-infected/ METH abusers and non-infected/non-METH abusers using MRI scans of a multiple areas including the thalamus, basal ganglia structures including the nucleus accumbens and caudate nucleus, hippocampus, amygdala, and the four outer lobes of the cerebral cortex.…”

Section: Hiv + Cocaine And/or Methamphetamine Neurotoxicitymentioning

confidence: 99%

Neurotoxic profiles of HIV, psychostimulant drugs of abuse, and their concerted effect on the brain: Current status of dopamine system vulnerability in NeuroAIDS

Ferris

Mactutus

Booze

2008

Neuroscience & Biobehavioral Reviews

119

131

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There are roughly 30 to 40 million HIV infected individuals in the world as of December 2007, and drug abuse directly contributes to one-third of all HIV-infections in the United States. Antiretroviral therapy has increased the lifespan of HIV-seropositives, but CNS function often remains diminished, effectively decreasing quality of life. A modest proportion may develop HIV-associated dementia, the severity and progression of which is increased with drug abuse. HIV and drugs of abuse in the CNS target subcortical brain structures and DA systems in particular. This toxicity is mediated by a number of neurotoxic mechanisms, including but not limited to, aberrant immune response and oxidative stress. Therefore, novel therapeutic strategies must be developed that can address a wide variety of disparate neurotoxic mechanisms and apoptotic cascades. This paper reviews the research pertaining to the where, what, and how of HIV and cocaine/methamphetamine toxicity in the CNS. Specifically, where these toxins most affect the brain, what aspects of the virus are neurotoxic, and how these toxins mediate neurotoxicity.

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Effects of HIV Seropositivity and Drug Abuse on Cognitive Function

Cited by 18 publications

References 0 publications

Neurologic manifestations of AIDS: a review of fifty cases in Santos

Neurologic manifestations of AIDS: a review of fifty cases in Santos

Assessment of Cognitive Function in Asymptomatic HIV-Positive Subjects

Neurotoxic profiles of HIV, psychostimulant drugs of abuse, and their concerted effect on the brain: Current status of dopamine system vulnerability in NeuroAIDS

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