Neurologic and Neuropsychological Manifestations of Human Immunodeficiency Virus Infection in Intravenous Drug Users Without Acquired Immunodeficiency Syndrome

Marder, Karen; Stern, Yaakov; Malouf, Renee; Tang, Mingxin; Bell, Karen L.; Dooneief, George; El‐Sadr, Wafaa; Goldstein, S.; Gorman, Jack M.; Richards, Marcus; Sano, Mary; Sorrell, Stephan; Todak, George; Williams, Janet B. W.; Ehrhardt, Anke Α.; Mayeux, Richard

doi:10.1001/archneur.1992.00530350083023

Cited by 34 publications

(25 citation statements)

References 16 publications

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“…Some investigators reported significant cognitive impairment among HIV+ compared with HIV− IDUs (Egan et al 1992; Marder et al 1992; Starace et al 1998), while others did not (Concha et al 1992; Hestad et al 1993; Selnes et al 1992). Virtually all studies reported higher prevalence of abnormal neuropsychological test scores among IDUs, regardless of serostatus, compared to the general population (e.g.…”

Section: Cns Effects Of Hiv Among Substance Dependent Individualsmentioning

confidence: 99%

Drug Abuse and Hepatitis C Infection as Comorbid Features of HIV Associated Neurocognitive Disorder: Neurocognitive and Neuroimaging Features

Martin-Thormeyer

Paul

2009

Neuropsychol Rev

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Substance abuse and co-infection with hepatitis C (HCV) are two highly relevant determinants of neurocognitive and neuroimaging abnormalities associated with HIV. Substance abuse and HCV are common in the HIV population and there is increasing evidence that the CNS is directly compromised by these comorbid conditions via additive or synergistic processes. In this article we review the current literature regarding mechanisms of neuronal injury as well as the neuropsychological and neuroimaging signatures associated with substance abuse and HCV status among HIV patients. We discuss specific methodological challenges and threats to validity associated with studies of HIV and comorbid substance use disorders or HCV and review potential strategies for minimizing their confounding effects. Efforts to understand the interactions between HIV, substance abuse and HCV co-infection will lead to more complete models of neuropathogenesis of HIV and a greater understanding of the variability in neuropsychological expression of HIV Associated Neurocognitive Disorder.

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Section: Cns Effects Of Hiv Among Substance Dependent Individualsmentioning

confidence: 99%

Drug Abuse and Hepatitis C Infection as Comorbid Features of HIV Associated Neurocognitive Disorder: Neurocognitive and Neuroimaging Features

Martin-Thormeyer

Paul

2009

Neuropsychol Rev

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“…Numerous studies to date have investigated the synergistic effects of psychoactive drugs and HIV on disease progression and neuropsychological (NP) functioning (Bornstein et al, 1993;Concha et al, 1992, Durvasula et al, 2000Marder et al, 1992, Selnes et al, 1997. These studies, which have largely examined the independent and interactive effects of heroin and cocaine abuse on NP functioning, have yielded mixed results, and most of these studies have been conducted with injection drug users.…”

Section: Relationship Between Alcohol Use/abuse Hiv Infection and Nementioning

confidence: 99%

Relationship between Alcohol Use/Abuse, HIV Infection and Neuropsychological Performance in African American Men

Durvasula

Myers

Mason

et al. 2006

Journal of Clinical and Experimental Neuropsychology

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This study examines the impact of alcohol use and HIV infection on neuropsychological performance in a sample of 497 community-resident African American men. HIV serostatus and alcohol use (during the past 12 months) exerted an interactive effect on psychomotor speed, reaction time, and motor speed, and in general, HIV infected heavy drinkers evidenced significantly poorer performance than other HIV positive subjects. Main effects for HIV serostatus were noted for reaction time, with seronegative men performing better than seropositives. This study examines a sample of men who continue to show increases in HIV infection, however, sample specific issues such as comorbid substance use, past histories of head injury, and lack of data on alcohol abuse and dependence require caution in definitively attributing the findings solely to alcohol and HIV. However, these findings suggest that relatively recent heavy alcohol use may represent a potential risk factor for more rapid or pronounced cognitive decline in HIV positive individuals, and that these patterns may be even more pronounced in persons with comorbid substance use. Relationship between Alcohol Use/Abuse, HIV Infection and Neuropsychological Performance in African American MenNumerous studies to date have investigated the synergistic effects of psychoactive drugs and HIV on disease progression and neuropsychological (NP) functioning (Bornstein et al., 1993;Concha et al., 1992, Durvasula et al., 2000Marder et al., 1992, Selnes et al., 1997. These studies, which have largely examined the independent and interactive effects of heroin and cocaine abuse on NP functioning, have yielded mixed results, and most of these studies have been conducted with injection drug users. No studies have demonstrated any interactive effects between drug use and HIV on NP performance. Some studies have reported no differences between asymptomatic injection drug users and seronegative controls Selnes et al., 1992). Bornstein et al. (1993) noted that neither recency nor severity of drug/alcohol abuse/dependence were associated with NP impairment in HIV infection - however, the drugs of abuse were not clearly specified in their study. To date, few studies have focused on whether HIV and alcohol consumption operate synergistically to produce more marked cognitive impairment in HIV infected samples. This is a noteworthy oversight given the relatively high rates of alcohol abuse and dependence among HIV positive individuals (Boscarino, Avins, Woods, Lindan, Hudes, & Clark, 1995). Alcohol Use and NP PerformanceThe adverse neuropsychological consequences of alcohol abuse and dependence are well documented. Mild to moderate NP deficits have been observed in individuals with histories of alcohol dependence (Oscar-Berman, Shagrin, Evert, & Epstein, 1997;Parsons & Nixon, 1993). Deficits are typically observed in attention, visuospatial functioning, executive functioning, and in learning and memory (Parsons & Nixon, 1993;Rourke & Loberg, 1996). There is a wide spectrum of effects as a fun...

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“…At the beginning of the neurological manifestation, all the subjects were given a standardised neurological examination [14, 15, 16], which was modified previously [17], by a single neurologist experienced in neuro-AIDS. This examination assessed the following systems/functions: cognitive state, brainstem, pyramidal system and extrapyramidal system.…”

Section: Methodsmentioning

confidence: 99%

Clinical Aspects of the AIDS Dementia Complex in Relation to Histopathological and Immunohistochemical Variables

Grassi¹,

Clerici²,

Vago³

et al. 2002

Eur Neurol

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To correlate cerebral histopathological and immunohistochemical changes in the neuroclinical features of the AIDS dementia complex (ADC), autopsy results of 28 ADC patients were related, in a retrospective analysis, to scores on a standardised neurological examination performed at neurologic onset. From a histopathological point of view, the cases were classified as follows: 9 cases of HIV leucoencephalopathy (HIVL; diffuse myelin damage and rare microglial nodules), 7 cases of HIV encephalitis (HIVE; several microglial nodules and no myelin damage) and 12 cases of mixed HIVL and HIVE (HIVL-E). The groups differed significantly with respect to symptoms and CD4 count at neurologic onset, survival and neurological impairment. Immunohistochemically, the interstitial component (p24-positive cells scattered singly within the white matter) was significantly more prevalent in HIVL, and the micronodular component (p24-positive cells confined within microglial nodules) in HIVE. Neurological damage was worse in cases with a high prevalence of interstitial component or a low prevalence of micronodular component. HIVE, HIVL and HIVL-E are distinct clinical forms of ADC. Neurological impairment is related to white matter damage.

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Neurologic and Neuropsychological Manifestations of Human Immunodeficiency Virus Infection in Intravenous Drug Users Without Acquired Immunodeficiency Syndrome

Cited by 34 publications

References 16 publications

Drug Abuse and Hepatitis C Infection as Comorbid Features of HIV Associated Neurocognitive Disorder: Neurocognitive and Neuroimaging Features

Drug Abuse and Hepatitis C Infection as Comorbid Features of HIV Associated Neurocognitive Disorder: Neurocognitive and Neuroimaging Features

Relationship between Alcohol Use/Abuse, HIV Infection and Neuropsychological Performance in African American Men

Clinical Aspects of the AIDS Dementia Complex in Relation to Histopathological and Immunohistochemical Variables

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