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Low prevalence of neurological and neuropsychological abnormalities in otherwise healthy HIV‐1–infected individuals: Results from the multicenter AIDS cohort study
Author(s) -
McArthur Justin C.,
Cohen Bruce A.,
Selnes Ola A.,
Kumar Ashok J.,
Cooper Kay,
McArthur Julie H.,
Soucy Gerry,
Cornblath David R.,
Chmiel Joan S.,
Wang MeiCheng,
Starkey Danna L.,
Ginzburg Harold,
Ostrow David G.,
Johnson Richard T.,
Phair John P.,
Polk B. Frank
Publication year - 1989
Publication title -
annals of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.764
H-Index - 296
eISSN - 1531-8249
pISSN - 0364-5134
DOI - 10.1002/ana.410260504
Subject(s) - medicine , multicenter aids cohort study , cohort , neuropsychology , dementia , neuropsychological test , pediatrics , cohort study , confounding , psychiatry , disease , human immunodeficiency virus (hiv) , sida , viral disease , immunology , cognition
Abstract Accurate description of the prevalence of neurological impairment in healthy individuals who are infected with human immunodeficiency virus type 1 (HIV‐1) has relevance for public health policy, for employment issues, and for planning future health needs. Within the Multicenter AIDS Cohort Study, we determined the cross‐sectional prevalence of neurological abnormalities in 270 HIV‐1 seropositive homosexual and bisexual men in Centers for Disease Control Groups II and III, using a control group of 193 HIV‐1 seronegative homosexual men. Utilizing a neurological and neuropsychological screening battery, we found no differences in the prevalence of neuropsychiatric symptoms or in neuropsychological performance. One hundred nineteen subjects with abnormalities on screening tests completed additional neuropsychological testing and had neurological examinations. The majority had normal results and the frequency of neurological abnormalities and impaired neuropsychological performance was not significantly increased among HIV‐1 seropositive subjects. Most of the abnormalities could be attributed to causes other than HIV‐1. One subject had mild HIV‐1–related dementia, yielding a prevalence of 3.7:1,000 (95% confidence interval: 0.19–23.7:1,000). Magnetic resonance imaging demonstrated sulcal prominence and focal areas of high signal intensity in white matter in 63% of HIV‐1 seropositive subjects and 48% of uninfected control subjects. Abnormalities in cerebrospinal fluid were noted in 23 (85%) of 27 HIV‐1–infected individuals. Our studies indicate that the prevalence of dementia and other HIV‐1–related neurological disorders is very low among healthy HIV‐1 seropositive homosexual men. The confounding effects of factors such a substance abuse or preexisting medical conditions must be considered in the neurological evaluation of such patients.