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Journal of Clinical and Experimental Neuropsychology Volume 30, 2008 - Issue 7
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Original Articles

An exploratory study of long-term neurocognitive outcomes following recovery from opportunistic brain infections in HIV+ adults

Andrew J. Levine University of California, Los Angeles–National Neurological AIDS Bank, Los Angeles, CA, USACorrespondence[email protected]
,
Charles H. Hinkin University of California, Los Angeles–National Neurological AIDS Bank, Los Angeles, CA, USA; Veterans Administration Greater Los Angeles Healthcare System, Los Angeles, CA, USA
,
Kazuhiro Ando University of California, Los Angeles–National Neurological AIDS Bank, Los Angeles, CA, USA
,
Gianni Santangelo University of California, Los Angeles–National Neurological AIDS Bank, Los Angeles, CA, USA
,
Mariana Martinez University of California, Los Angeles–National Neurological AIDS Bank, Los Angeles, CA, USA
,
Miguel Valdes-Sueiras University of California, Los Angeles–National Neurological AIDS Bank, Los Angeles, CA, USA; Department of Medicine, Olive View–UCLA Medical Center, Sylmar, CA, USA; AIDS Healthcare Foundation, Los Angeles, CA, USA
,
Ernestina H. Saxton University of California, Los Angeles–National Neurological AIDS Bank, Los Angeles, CA, USA
,
Glen Mathisen University of California, Los Angeles–National Neurological AIDS Bank, Los Angeles, CA, USA; Department of Medicine, Olive View–UCLA Medical Center, Sylmar, CA, USA; Department of Internal Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
,
Deborah L. Commins University of California, Los Angeles–National Neurological AIDS Bank, Los Angeles, CA, USA; Department of Pathology, University of Southern California University Hospital, Los Angeles, CA, USA
,
Ardis Moe University of California, Los Angeles–National Neurological AIDS Bank, Los Angeles, CA, USA; Department of Internal Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
,
Charles Farthing University of California, Los Angeles–National Neurological AIDS Bank, Los Angeles, CA, USA; AIDS Healthcare Foundation, Los Angeles, CA, USA
&
Elyse J. Singer University of California, Los Angeles–National Neurological AIDS Bank, Los Angeles, CA, USA
 show all
Pages 836-843 | Received 12 Sep 2007, Accepted 19 Nov 2007, Published online: 05 Sep 2008
 
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Abstract

Central nervous system opportunistic infections (CNS-OI) are a significant cause of morbidity and mortality in AIDS. While current interventions are increasingly successful in treating CNS-OI, little information exists regarding long-term behavioral outcomes among survivors. In this exploratory study we examined neurocognitive data among three groups of adults with different AIDS-related CNS-OI: 15 with past cryptococcal meningitis (CM), 8 with toxoplasmosis encephalitis (TE), and 8 with progressive multifocal leukoencephalopathy (PML). A group of 61 individuals with AIDS, but without CNS-OI, was used as a comparison group. A battery of standardized neuropsychological tests assessing a variety of cognitive domains was administered upon entry. Results indicate that individuals with a history of CNS-OI were most impaired on measures of cognitive and psychomotor speed relative to the HIV+ comparison group. Among the CNS-OI groups, individuals with history of TE had the most severe and varied deficits. The results are discussed in relation to what is known about the neuropathological consequences of the various CNS-OIs. While this is the first systematic group study of residual CNS-OI effects on neurocognitive function, future studies employing more participants, perhaps focusing on specific CNS-OIs, will further characterize the long-term outcomes in AIDS-related CNS-OI.

This study was supported by Grant NS38841, National Neurological AIDS Bank.

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