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The neuropsychological profile of symptomatic AIDS and ADC patients in the pre-HAART era: A meta-analysis

Published online by Cambridge University Press:  17 May 2006

LUCETTE A.J. CYSIQUE ,
PAUL MARUFF  and
BRUCE J. BREW
LUCETTE A.J. CYSIQUE
Affiliation:
Faculty of Medicine, St. Vincent's Clinical School, University of New South Wales, Sydney, Australia
PAUL MARUFF
Affiliation:
School of Psychology, LaTrobe University, Melbourne, Australia
BRUCE J. BREW
Affiliation:
Departments of Neurology and HIV Medicine, St. Vincent's Hospital, Sydney, Australia
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Abstract

It remains essential to document the neuropsychological profile of acquired immunodeficiency syndrome (AIDS) dementia complex (ADC) and minor forms human immunodeficiency virus (HIV)-associated neurocognitive impairment by quantifying the magnitude of impairment across eras of treatment. Indeed, with the introduction of the highly active antiretroviral therapy (HAART), there is evidence of changes in aspects of ADC. To allow quantitative and qualitative comparisons with the HAART era studies, we developed a summary of neuropsychological performance acquired in pre-HAART era studies in advanced HIV infection and ADC. Using a meta-analytical procedure and a test nomenclature that accounts for task complexity, we found that individuals with symptomatic infection (but no AIDS) demonstrated a global mild level of cognitive impairment, except for the domains complex attention/psychomotor speed, motor coordination, and learning, which showed moderate impairment. Individuals with AIDS demonstrated a global moderate level of cognitive impairment with a predominance of deficits in attention, complex attention/psychomotor speed, learning, motor coordination, with additional deficits in verbal memory and reasoning. Individuals with ADC demonstrated the most severe cognitive disturbances in domains of learning, motor coordination, with additional deficits in verbal fluency and verbal memory. Moderate impairment was evidenced in domains of complex attention/psychomotor speed, whereas naming and visuospatial functions were relatively preserved. The profile of deficits in ADC suggests that it may not be only interpreted as a worsening form of the impairment that is seen in the AIDS and symptomatic stages of HIV disease but that there are also additional deficits suggestive of an alternate pathogenetic process(es). (JINS, 2006, 12, 368–382.)

Keywords

AIDS dementia complexHIV/AIDSNeuropsychological functioningCognitionNeuropsychologyMeta-analysis
Type
Research Article
Information
Journal of the International Neuropsychological Society , Volume 12 , Issue 3 , May 2006 , pp. 368 - 382
Copyright
© 2006 The International Neuropsychological Society

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