| Abstract | BACKGROUND: Combination antiretroviral therapy including protease inhibitors (combo+PI) is effective in suppressing systemic viral load in HIV infection, but its impact on HIV-associated cognitive impairment is unclear. OBJECTIVE: To determine whether psychomotor speed, a sensitive measure of impairment in HIV dementia, improves with combo+PI compared with other antiretroviral treatments. METHODS: A total of 411 HIV-seropositive (HIV+) homosexual men (with longitudinal neuropsychological testing) in the Multicenter AIDS Cohort Study and, in a separate analysis, 282 HIV+ homosexual men with psychomotor slowing at baseline were classified by treatment into four groups: antiretroviral naive (no antiretroviral medication treatment), monotherapy, combination antiretroviral therapy without protease inhibitors (combo-noPI), and combo+PI. We compared longitudinal performance on three tests of psychomotor speed: the Grooved Pegboard (GP) (nondominant and dominant hands), Trail Making Test B, and the Symbol Digit Modalities Test (SDMT). RESULTS: Relative to antiretroviral-naïve and monotherapy participants, on the GP nondominant hand test, combo+PI participants with abnormal baseline neuropsychological testing showed improved performance (difference = +0.63 standard deviation [SD], p = 0.02). For the SDMT, both combo+PI participants (difference = +0.26 SD, p = 0.03) and combo-noPI participants (difference = +0.29 SD, p = 0.01) with abnormal baseline neuropsychological testing improved compared with antiretroviral-naïve and monotherapy groups. CONCLUSION: Combo+PI and combo-noPI are associated with improved psychomotor speed performance in HIV+ homosexual men with abnormal neuropsychological testing. |
| Authors | N C Sacktor, R H Lyles, R L Skolasky, D E Anderson, J C McArthur, G McFarlane, O A Selnes, J T Becker, B Cohen, J Wesch, E N Miller
(Affiliation: Department of Neurology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.)
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| Journal | Neurology
(Neurology)
Vol. 52
Issue 8
Pg. 1640-7
(May 12 1999)
ISSN: 0028-3878 UNITED STATES |
| PMID | 10331692
(Publication Type: Clinical Trial, Journal Article, Multicenter Study, Research Support, U.S. Gov't, P.H.S.)
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| Chemical References |
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| Topics |
- Adult
- Anti-HIV Agents
(therapeutic use)
- Drug Therapy, Combination
- HIV Infections
(drug therapy, psychology)
- HIV Seropositivity
(drug therapy)
- Humans
- Male
- Middle Aged
- Neuropsychological Tests
- Prospective Studies
- Psychomotor Performance
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