The neuropsychological profile of symptomatic AIDS and ADC patients in the pre-HAART era: A meta-analysis

Abstract

It remains essential to document the neuropsychological profile of acquired immunodeficiency syndrome (AIDS) dementia complex (ADC) and minor forms human immunodeficiency virus (HIV)-associated neurocognitive impairment by quantifying the magnitude of impairment across eras of treatment. Indeed, with the introduction of the highly active antiretroviral therapy (HAART), there is evidence of changes in aspects of ADC. To allow quantitative and qualitative comparisons with the HAART era studies, we developed a summary of neuropsychological performance acquired in pre-HAART era studies in advanced HIV infection and ADC. Using a meta-analytical procedure and a test nomenclature that accounts for task complexity, we found that individuals with symptomatic infection (but no AIDS) demonstrated a global mild level of cognitive impairment, except for the domains complex attention0psychomotor speed, motor coordination, and learning, which showed moderate impairment. Individuals with AIDS demonstrated a global moderate level of cognitive impairment with a predominance of deficits in attention, complex attention0psychomotor speed, learning, motor coordination, with additional deficits in verbal memory and reasoning. Individuals with ADC demonstrated the most severe cognitive disturbances in domains of learning, motor coordination, with additional deficits in verbal fluency and verbal memory. Moderate impairment was evidenced in domains of complex attention0psychomotor speed, whereas naming and visuospatial functions were relatively preserved. The profile of deficits in ADC suggests that it may not be only interpreted as a worsening form of the impairment that is seen in the AIDS and symptomatic stages of HIV disease but that there are also additional deficits suggestive of an alternate pathogenetic process(es). (JINS, 2006, 12, 368-382.)

Neurobehavioral effects of HIV-1 infection in China and the United States: A pilot study

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Neuropsychological Functioning and Antiretroviral Treatment in HIV/AIDS: A Review

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Neurodegeneration and Ageing in the HAART Era

“…This was empirically demonstrated in a study comparing young adults with HAND and older healthy individuals (Hinkin et al 1990). Specifically, attentional processes inclusive of complex attention, speed of information processing, and working memory are primarily affected by ageing (Glisky 2007;Kramer and Madden 2008) as well as HAND (Cysique et al 2006b;Reger et al 2002;Woods et al 2008b). Neuropsychological findings for attentional deficits in ageing show a decreased capacity for dividing and switching between tasks.…”