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Publication Abstract Display
Type: Published Abstract
Title: Value of neurocognitive status in predicting HIV-related brain disease.
Authors: Cherner M, Masliah E, Heaton R, Ellis R, Grant I, and the HNRC Group
Year: 2001
Publication: Journal of the International Neuropsychological Society
Volume: 7 Issue: 2 Pages: 150
Abstract:Previous work by our group has shown relationships between cognitive impairment and neuropathologic evidence of HIV-related brain disease. The present study used a larger sample to investigate the predictive value of antemortem cognitive functioning in detecting postmortem evidence of HIV encephalitis (HIVE). Thirty-nine HIV1 study participants were assessed during life with a comprehensive neuropsychological battery. Cognitive impairment was determined by blind clinical ratings based on demographically corrected scores for all tests. Presence or absence of HIVE was defined on the basis of post-mortem immunocytochemical detection of the viral protein gp41 in multiple brain areas, and by histopathologic evidence, such as presence of multinucleated giant cells, microgliosis, and myelin pallor in several brain regions. Of 18 Ss with NP impairment, 17 (94%) had evidence of HIVE. By contrast, of 21 NP normal individuals, 10 (48%) showed postmortem HIVE. The sensitivity and specificity of our NP diagnosis in detecting the occurrence of HIV encephalitis with neurodegeneration were 63% and 92% respectively. Presence of NP impairment in life was almost always predictive of HIVE in our sample. These results suggest that if NP impairment is detected, there is a strong likelihood that HIV-related changes will be evident in brain tissue. NP diagnosis can be a powerful tool in selecting HIV1 patients for pharmacologic treatments that target the CNS.

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