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

J Clin Exp Neuropsychol. 2008 Oct;30(7):836-43. doi: 10.1080/13803390701819036. Epub 2008 Feb 8.

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.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Analysis of Variance
  • Cognition Disorders / etiology*
  • Cognition Disorders / virology
  • Cross-Cultural Comparison
  • Cytomegalovirus Infections / pathology
  • Cytomegalovirus Infections / virology
  • Encephalitis, Viral / complications*
  • Encephalitis, Viral / etiology*
  • Female
  • HIV Infections / complications*
  • Humans
  • Longitudinal Studies
  • Male
  • Mental Processes / physiology
  • Middle Aged
  • Neurologic Examination / methods
  • Neuropsychological Tests
  • Psychiatric Status Rating Scales
  • Recovery of Function / physiology*
  • Toxoplasmosis, Cerebral / pathology
  • Toxoplasmosis, Cerebral / virology