| Publication Abstract Display | | Type: Published Abstract | | Title: Cognitive decline over one year among HIV-infected former plasma donors in China. | | Authors: Cysique LA, Letendre S, Gupta S, Jin H, Franklin D, Shi C, Yu X, Wu Z, Ake C, Wolfson T, Abrahamson I, Grant I, Heaton RK, and the HNRC Group | | Year: 2009 | | Publication: Journal of NeuroVirology | | Volume: 15 Issue: S1 Pages: 19 | | Abstract:Objective: To quantify incidence and nature of cognitive decline over one year in a cohort of HIV-infected (HIV + ) former plasma donors in China, using Western neuropsychological (NP) tests and normative standards that adjust for practice effect (PE) and other factors affecting test-retest variability.
Methods: We developed norms for change using the NP data from 101 demographically comparable HIV-negative (HIV − ) former plasma donors. The NP test battery covered seven cognitive ability domains. We used the multiple regression change score approach with the HIV− sample to derive the norms for change that were then be applied to 192 HIV+ participants. Followup test scores were adjusted for the control group median PE to more precisely classify NP impairment at the second testing.
Results: Among the HIV+ individuals, 27% (N = 53) developed significant cognitive decline. Baseline history of immunosuppression, lower CD4 at followup, lower viral load when on cART, AIDS status, and lower baseline performance in processing speed were associated with cognitive decline. NP decline also was associated with decreased independence in accomplishing activities of daily living. Using NP-impairment scores that were PE-corrected, we found that among the decliners, 41.5% (N = 22) had incident impairment, 38% (N = 20) declined within the impaired range and another 20.7% (N = 11) declined within the normal range.
Conclusion: This study is the first to adapt regression-based norms for NP change in a developing country. Substantial cognitive decline and persistence of NP-impairment despite cART confirm that neurocognitive complications in HIV-infection remain a concern worldwide. |
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