Can high central nervous system penetrating antiretroviral regimens protect against the onset of HIV-associated neurocognitive disorders?

• DOI: 10.1097/qad.0000000000000096
• Publication Date: 2013-10-18T06:59:26Z
• Authors: Matteo Vassallo; Jacques Durant; Virginie Biscay; Christine Lebrun-...; Brigitte Dunais; Muriel Laffon; Alexandra Harvey-...; Jacqueline Cottal...; Michel Ticchioni; Helene Carsenti; Christian Pradier; Pierre Dellamonica
• Keywords: Neurocognitive; Neuropsychological test

Objective: To assess changes over time in neuropsychological test results (NPr) and risk factors among a regularly followed HIV-infected patient population. Methods: Prospective cohort of patients randomly selected to undergo follow-up. Test score was adjusted for age, sex education. Patients were divided into five groups: normal tests, deficit (one impaired cognitive domain), asymptomatic neurocognitive disorders (ANIs), mild (MNDs) HIV-associated dementia (HAD). Demographic background parameters including CSF drug concentration penetration effectiveness (CPE) 2010 recorded. Changes NPr associated analyzed. Results: Two hundred fifty-six underwent tests 96 accepted follow-up approximately 2 years later. The groups comparable. Upon retesting, six improved, 31 worsened 59 stable. proportion with (HANDs) rose from 26 45%, ANIs MNDs still mostly represented. Most initially diagnosed HANDs remained stable, 25 showed clinical improvement three deteriorated. Of 33 four deteriorated, whereas 24 38 initial had poorer NPr, contributed most the new HAND cases. deterioration lower CPE both at inclusion (6.9 vs. 8.1; P = 0.005) end (7.2 7.8; 0.08) than those improved or stable performance. This confirmed by multivariate analysis. Conclusion: higher scores upon worsening, suggesting that combination antiretroviral therapy better could protect against deterioration.