Positive and sustained effects of highly active antiretroviral therapy on HIV-1-associated neurocognitive impairment

Valerio Tozzi, Pietro Balestra, Simonetta Galgani, Pasquale Narciso, Fabrizio Ferri, Gabriella Sebastiani, Carmelo D'Amato, Cesare Affricano, Francesco Pigorini, Franca Maria Pau, Annapaola De Felici, Arrigo Benedetto

Research output: Contribution to journalArticle

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Abstract

Objectives: To determine whether highly active antiretroviral therapy (HAART) is effective in HIV-associated neurocognitive impairment. Design: An open label, prospective, observational study. Methods: Since April 1996, 116 patients with advanced HIV infection, reverse transcriptase inhibitor (nRTI) experienced but protease inhibitor (PI) naive, were screened for the presence of neurocognitive impairment. Ninety patients with confounding neurological illness, opportunistic infections or drug abuse were excluded. The remaining 26 patients underwent comprehensive neuropsychological testing, and laboratory measures before, after 6 and after 15 months of treatment with one PI plus two nRTI. Results: The prevalence of neurocognitive impairment decreased from 80.8% (baseline) to 50.0% (P <0.05) (sixth month) and to 21.7% (P <0.001) (15th month). Among the functions explored, the impairment of concentration and speed of mental processing decreased from 65.4 to 21.7% (P <0.01) and of memory impairment from 50 to 8.7% (P <0.01). Comparing baseline with the sixth and 15th month raw scores, a statistically significant improvement was seen in measures exploring concentration and speed of mental processing (P <0.05), mental flexibility (P <0.05), memory (P <0.05), fine motor functions (P <0.05) and visuospatial and constructional abilities (P <0.01). After 6 months of HAART patients with a normal neuropsychological examination had lower mean plasma viraemia (2.95 versus 3.97 log copies/ml, P <0.05) and greater mean log plasma HIV RNA changes from baseline (-1.84 versus -0.83 log copies/ml, P <0.05) than neuropsychologically impaired subjects. Conclusion: HAART produces a positive and sustained effect on neurocognitive impairment in HIV-infected patients. A reduction of plasma viral load was associated with the regression of neuropsychological test abnormalities.

Original languageEnglish
Pages (from-to)1889-1897
Number of pages9
JournalAIDS (London, England)
Volume13
Issue number14
DOIs
Publication statusPublished - 1999

Fingerprint

Highly Active Antiretroviral Therapy
HIV-1
HIV
Protease Inhibitors
HIV Reverse Transcriptase
Aptitude
Reverse Transcriptase Inhibitors
Neuropsychological Tests
Viremia
Opportunistic Infections
Viral Load
HIV Infections
Substance-Related Disorders
Observational Studies
Prospective Studies
RNA

Keywords

  • AIDS dementia complex
  • Highly active antiretroviral therapy
  • HIV-1
  • Neurocognitive impairment
  • Protease inhibitors

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology

Cite this

Tozzi, V., Balestra, P., Galgani, S., Narciso, P., Ferri, F., Sebastiani, G., ... Benedetto, A. (1999). Positive and sustained effects of highly active antiretroviral therapy on HIV-1-associated neurocognitive impairment. AIDS (London, England), 13(14), 1889-1897. https://doi.org/10.1097/00002030-199910010-00011

Positive and sustained effects of highly active antiretroviral therapy on HIV-1-associated neurocognitive impairment. / Tozzi, Valerio; Balestra, Pietro; Galgani, Simonetta; Narciso, Pasquale; Ferri, Fabrizio; Sebastiani, Gabriella; D'Amato, Carmelo; Affricano, Cesare; Pigorini, Francesco; Pau, Franca Maria; De Felici, Annapaola; Benedetto, Arrigo.

In: AIDS (London, England), Vol. 13, No. 14, 1999, p. 1889-1897.

Research output: Contribution to journalArticle

Tozzi, V, Balestra, P, Galgani, S, Narciso, P, Ferri, F, Sebastiani, G, D'Amato, C, Affricano, C, Pigorini, F, Pau, FM, De Felici, A & Benedetto, A 1999, 'Positive and sustained effects of highly active antiretroviral therapy on HIV-1-associated neurocognitive impairment', AIDS (London, England), vol. 13, no. 14, pp. 1889-1897. https://doi.org/10.1097/00002030-199910010-00011
Tozzi, Valerio ; Balestra, Pietro ; Galgani, Simonetta ; Narciso, Pasquale ; Ferri, Fabrizio ; Sebastiani, Gabriella ; D'Amato, Carmelo ; Affricano, Cesare ; Pigorini, Francesco ; Pau, Franca Maria ; De Felici, Annapaola ; Benedetto, Arrigo. / Positive and sustained effects of highly active antiretroviral therapy on HIV-1-associated neurocognitive impairment. In: AIDS (London, England). 1999 ; Vol. 13, No. 14. pp. 1889-1897.
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AU - Galgani, Simonetta

AU - Narciso, Pasquale

AU - Ferri, Fabrizio

AU - Sebastiani, Gabriella

AU - D'Amato, Carmelo

AU - Affricano, Cesare

AU - Pigorini, Francesco

AU - Pau, Franca Maria

AU - De Felici, Annapaola

AU - Benedetto, Arrigo

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N2 - Objectives: To determine whether highly active antiretroviral therapy (HAART) is effective in HIV-associated neurocognitive impairment. Design: An open label, prospective, observational study. Methods: Since April 1996, 116 patients with advanced HIV infection, reverse transcriptase inhibitor (nRTI) experienced but protease inhibitor (PI) naive, were screened for the presence of neurocognitive impairment. Ninety patients with confounding neurological illness, opportunistic infections or drug abuse were excluded. The remaining 26 patients underwent comprehensive neuropsychological testing, and laboratory measures before, after 6 and after 15 months of treatment with one PI plus two nRTI. Results: The prevalence of neurocognitive impairment decreased from 80.8% (baseline) to 50.0% (P <0.05) (sixth month) and to 21.7% (P <0.001) (15th month). Among the functions explored, the impairment of concentration and speed of mental processing decreased from 65.4 to 21.7% (P <0.01) and of memory impairment from 50 to 8.7% (P <0.01). Comparing baseline with the sixth and 15th month raw scores, a statistically significant improvement was seen in measures exploring concentration and speed of mental processing (P <0.05), mental flexibility (P <0.05), memory (P <0.05), fine motor functions (P <0.05) and visuospatial and constructional abilities (P <0.01). After 6 months of HAART patients with a normal neuropsychological examination had lower mean plasma viraemia (2.95 versus 3.97 log copies/ml, P <0.05) and greater mean log plasma HIV RNA changes from baseline (-1.84 versus -0.83 log copies/ml, P <0.05) than neuropsychologically impaired subjects. Conclusion: HAART produces a positive and sustained effect on neurocognitive impairment in HIV-infected patients. A reduction of plasma viral load was associated with the regression of neuropsychological test abnormalities.

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