Effects of highly active antiretroviral therapy on cognitive functions in severely immune-compromised HIV-seropositive patients

Obiabo, Yahaya; Ogunrin, Olubunmi; Ogun, Abayomi S.

doi:10.1016/j.jns.2011.09.011

Cited by 14 publications

(13 citation statements)

References 41 publications

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“…Given the complexities of capturing this data longitudinally across diverse sites, the study lacked longitudinal norms and thus was limited in its ability to address whether the improvement was due to improved CNS functioning, greater overall health, practice effects, or a combination of these factors. Similarly, a recent study from Nigeria reported that ART helped in significantly improving cognitive performances among treated HIV positive patients in all tested domains with the exception of motor speed (Obiabo et al 2012), although the authors did not adjust for possible practice effects.…”

Section: Discussionmentioning

confidence: 99%

The effects of antiretroviral treatment initiation on cognition in HIV-infected individuals with advanced disease in Pune, India

et al. 2015

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There has been a reduction in the most severe cases of HIV-associated neurocognitive disorders (HAND) with advances in antiretroviral treatment (ART). But the prevalence of milder forms of HAND still remains high. Data from systematically conducted studies on the effects of ART on cognition are scanty in India where HIV-1 clade C is prevalent. The purpose of the present study was to assess the effect of antiretroviral therapy in HIV seropositive (HIV+) individuals (n = 92) with CD4 cell counts < 200 cells/mm3. Overall and domain-specific levels of cognitive functioning were determined using a locally-recruited normative sample and change in neurocognitive functioning at the one-year follow-up visit was analyzed. Results revealed cognitive impairment in 44.6% of the HIV+ group at baseline. At the one-year follow-up, the group showed significant improvement in the Learning domain (p<0.05). HIV+ individuals showing improvement in the global cognitive scores had a significantly lower baseline CD4 cell count compared to others. Overall, the degree of improvement associated with the magnitude of rise in CD4 suggests the possibility that early, mild subclinical declines may also benefit from treatment.

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Section: Discussionmentioning

confidence: 99%

The effects of antiretroviral treatment initiation on cognition in HIV-infected individuals with advanced disease in Pune, India

et al. 2015

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“…[6] The use of HAART has been shown to boost CD4 count restoring immunity, decrease the incidence of opportunistic infections and thus better tolerance to chemotherapy. [7,8] Although the tolerability of HAART with chemotherapy has been noted in several studies, our case developed neutropaenia up to 500 cells/mm3. This was due to the zidovudine component in the initial HAART combination of (zidovudine, lamuvidine and nevirapine).…”

Section: Discussionmentioning

confidence: 59%

Chemotherapy In HIV Associated Systemic Lymphoma With CNS Involvement- Experience With A Case

E.A¹,

Y.O²

2017

Ann. Int. Med. Den. Res.

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We report the case of a 49 year old health worker, HIV positive, who presented with a 2 months history of a rapidly enlarging cervical lymphadenopathy, right breast lump, hearing loss and weight loss. Disease progressed to a right facial nerve palsy, upper motor neurone type with right hemiparesis. CD 4 count was at 80/mm3 and Brain CT showed a left temporal lobe mass. She had a reversal of neurologic deficit within 72 hours with administration of doxorubicin. She continued cyclical chemotherapy with doxorubicin, vincristine , cyclophosphamide and later etoposide with intrathecal methotrexate, making a full recovery with complete resolution of the temporal lobe mass and neurologic symptoms. Granulocyte colony stimulating factor support, repeated blood transfusion and substitution of zidovudine containing HAART emerged effective strategies in achieving success.

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“…Interestingly, older adults tend to have higher current CD4 counts than younger HIV+ adults, which has been independently correlated with the presence of DSP and worse motor performance among HIV+ individuals (Castelo et al, 2007; Morgello et al, 2004). There is evidence that motor deficits persist even after the initiation of antiretroviral therapy, despite increased CD4 count and improvement in other neurocognitive domains (Obiabo, Ogunrin, & Ogun, 2012). Considering that participants with DSP in the current study were older and had a higher rate of impairment limited to domains with psychomotor tests, it is possible that increased intra-individual score dispersion among older HIV+ individuals with neurocognitive impairment in other studies is exacerbated by peripherally mediated sensory loss in the upper extremities.…”

Section: Discussionmentioning

confidence: 99%

Distal Sensory Polyneuropathy is Associated with Neuropsychological Test Performance among Persons with HIV

Fellows

Byrd

Elliott

et al. 2012

J Int Neuropsychol Soc

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AbstractWhile distal sensory polyneuropathy (DSP) is the most common neurological condition associated with HIV, causing nerve damage in upper and lower extremities, its impact on neuropsychological test performance is unclear. In this study, we analyzed baseline data for 278 HIV-infected participants with comprehensive neurological and neurocognitive evaluations to examine the contribution of DSP and anatomic distribution of neuropathic signs (upper extremity or lower extremity) on standardized domain scores. We found that participants with DSP performed significantly worse in multiple domains containing timed psychomotor tests (i.e., motor, information processing speed and executive functioning). With regard to executive functioning, differences were limited to a test with a motor component (Trail Making Test, Part B). The group with clinically detectable neuropathic signs in the upper extremities and the group with signs limited to the lower extremities both performed worse in the motor domain than the group without DSP. Participants with DSP demonstrated a unique pattern of impairment limited to neuropsychological domains with timed psychomotor tests. These results suggest that caution should be used in interpretation of neuropsychological tests in patients with DSP, as some abnormalities may be exacerbated by peripheral nervous system pathology. (JINS, 2012,19, 1–10)

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Effects of highly active antiretroviral therapy on cognitive functions in severely immune-compromised HIV-seropositive patients

Cited by 14 publications

References 41 publications

The effects of antiretroviral treatment initiation on cognition in HIV-infected individuals with advanced disease in Pune, India

The effects of antiretroviral treatment initiation on cognition in HIV-infected individuals with advanced disease in Pune, India

Chemotherapy In HIV Associated Systemic Lymphoma With CNS Involvement- Experience With A Case

Distal Sensory Polyneuropathy is Associated with Neuropsychological Test Performance among Persons with HIV

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