Acute and early HIV-infected persons evidence learning impairments.

Type: Poster
Title: Acute and early HIV-infected persons evidence learning impairments.
Authors: Moore DJ, Letendre SL, Deutsch R, Little S, Smith D, Morris S, Franklin DR, Gouaux B, LeBlanc S, Rosario D, Heaton RK, Ellis R, Atkinson JH, Grant I, for the CHARTER Group
Date: 02-03-2010
Abstract:Objectives: The present study examined the level of neuropsychological (NP) functioning among persons with acute and early HIV (AEH) infection as compared to HIV seronegative (HIV-) controls and assessed the association between HIV disease and treatment characteristics associated with NP functioning in AEH individuals. Methods: We examined 77 AEH participants as compared to 52 demographically matched HIV- comparison participants. All AEH participants were determined to be HIV+ for less than one year with a mean duration of infection of 20.2 (14.6) weeks. Seventy-seven percent of AEH participants were treatment naïve. All study participants were evaluated with a comprehensive neuropsychological battery assessing seven domains of functioning. We examined group differences on NP functioning and assessed associations between HIV disease and treatment characteristics and NP functioning. Results: Using a global deficit score, AEH persons had significantly worse NP performance as compared to HIV- individuals (p=0.04); 26% of AEH participants were classified as NP impaired as compared to 13% among HIV- controls. AEH participants also performed significantly worse in the domain of learning as compared to HIV- controls (p<0.025). Among AEH participants, those with worse NP functioning showed higher peak plasma viral loads (p=0.04, ρ=0.25). Conclusions: AEH individuals showed NP impairment, which was associated with higher peak plasma viral loads. AEH individuals also evidenced significantly more deficits in learning as compared to HIV- participants. Findings point to possible early disruptions of frontal-subcortical systems typically involved in learning abilities. If confirmed, the results indicate that early antiviral treatment (ART), perhaps including ART with good CNS penetration, may be indicated to suppress viral replication and prevent or ameliorate possible neurocognitive complications.