Neurocognitive function in HIV infected patients on antiretroviral therapy.
<h4>Objective</h4>To describe factors associated with neurocognitive (NC) function in HIV-positive patients on stable combination antiretroviral therapy.<h4>Design</h4>We undertook a cross-sectional analysis assessing NC data obtained at baseline in patients entering the Prot...
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Public Library of Science (PLoS)
2013-01-01
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| Series: | PLoS ONE |
| Online Access: | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0061949&type=printable |
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| author | Alan Winston Alejandro Arenas-Pinto Wolfgang Stöhr Martin Fisher Chloe M Orkin Kazeem Aderogba Andrew De Burgh-Thomas Nigel O'Farrell Charles Jn Lacey Clifford Leen David Dunn Nicholas I Paton PIVOT Trial Team |
| author_facet | Alan Winston Alejandro Arenas-Pinto Wolfgang Stöhr Martin Fisher Chloe M Orkin Kazeem Aderogba Andrew De Burgh-Thomas Nigel O'Farrell Charles Jn Lacey Clifford Leen David Dunn Nicholas I Paton PIVOT Trial Team |
| author_sort | Alan Winston |
| collection | DOAJ |
| description | <h4>Objective</h4>To describe factors associated with neurocognitive (NC) function in HIV-positive patients on stable combination antiretroviral therapy.<h4>Design</h4>We undertook a cross-sectional analysis assessing NC data obtained at baseline in patients entering the Protease-Inhibitor-Monotherapy-Versus-Ongoing-Triple therapy (PIVOT) trial.<h4>Main outcome measure</h4>NC testing comprised of 5 domains. Raw results were z-transformed using standard and demographically adjusted normative datasets (ND). Global z-scores (NPZ-5) were derived from averaging the 5 domains and percentage of subjects with test scores >1 standard deviation (SD) below population means in at least two domains (abnormal Frascati score) calculated. Patient characteristics associated with NC results were assessed using multivariable linear regression.<h4>Results</h4>Of the 587 patients in PIVOT, 557 had full NC results and were included. 77% were male, 68% Caucasian and 28% of Black ethnicity. Mean (SD) baseline and nadir CD4+ lymphocyte counts were 553(217) and 177(117) cells/µL, respectively, and HIV RNA was <50 copies/mL in all. Median (IQR) NPZ-5 score was -0.5 (-1.2/-0) overall, and -0.3 (-0.7/0.1) and -1.4 (-2/-0.8) in subjects of Caucasian and Black ethnicity, respectively. Abnormal Frascati scores using the standard-ND were observed in 51%, 38%, and 81%, respectively, of subjects overall, Caucasian and Black ethnicity (p<0.001), but in 62% and 69% of Caucasian and Black subjects using demographically adjusted-ND (p = 0.20). In the multivariate analysis, only Black ethnicity was associated with poorer NPZ-5 scores (P<0.001).<h4>Conclusions</h4>In this large group of HIV-infected subjects with viral load suppression, ethnicity but not HIV-disease factors is closely associated with NC results. The prevalence of abnormal results is highly dependent on control datasets utilised.<h4>Trial registry</h4>ClinicalTrials.gov, NCT01230580. |
| format | Article |
| id | doaj-art-52ca083eb1e9427e8b6acb19958f2183 |
| institution | OA Journals |
| issn | 1932-6203 |
| language | English |
| publishDate | 2013-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj-art-52ca083eb1e9427e8b6acb19958f21832025-08-20T02:05:32ZengPublic Library of Science (PLoS)PLoS ONE1932-62032013-01-0184e6194910.1371/journal.pone.0061949Neurocognitive function in HIV infected patients on antiretroviral therapy.Alan WinstonAlejandro Arenas-PintoWolfgang StöhrMartin FisherChloe M OrkinKazeem AderogbaAndrew De Burgh-ThomasNigel O'FarrellCharles Jn LaceyClifford LeenDavid DunnNicholas I PatonPIVOT Trial Team<h4>Objective</h4>To describe factors associated with neurocognitive (NC) function in HIV-positive patients on stable combination antiretroviral therapy.<h4>Design</h4>We undertook a cross-sectional analysis assessing NC data obtained at baseline in patients entering the Protease-Inhibitor-Monotherapy-Versus-Ongoing-Triple therapy (PIVOT) trial.<h4>Main outcome measure</h4>NC testing comprised of 5 domains. Raw results were z-transformed using standard and demographically adjusted normative datasets (ND). Global z-scores (NPZ-5) were derived from averaging the 5 domains and percentage of subjects with test scores >1 standard deviation (SD) below population means in at least two domains (abnormal Frascati score) calculated. Patient characteristics associated with NC results were assessed using multivariable linear regression.<h4>Results</h4>Of the 587 patients in PIVOT, 557 had full NC results and were included. 77% were male, 68% Caucasian and 28% of Black ethnicity. Mean (SD) baseline and nadir CD4+ lymphocyte counts were 553(217) and 177(117) cells/µL, respectively, and HIV RNA was <50 copies/mL in all. Median (IQR) NPZ-5 score was -0.5 (-1.2/-0) overall, and -0.3 (-0.7/0.1) and -1.4 (-2/-0.8) in subjects of Caucasian and Black ethnicity, respectively. Abnormal Frascati scores using the standard-ND were observed in 51%, 38%, and 81%, respectively, of subjects overall, Caucasian and Black ethnicity (p<0.001), but in 62% and 69% of Caucasian and Black subjects using demographically adjusted-ND (p = 0.20). In the multivariate analysis, only Black ethnicity was associated with poorer NPZ-5 scores (P<0.001).<h4>Conclusions</h4>In this large group of HIV-infected subjects with viral load suppression, ethnicity but not HIV-disease factors is closely associated with NC results. The prevalence of abnormal results is highly dependent on control datasets utilised.<h4>Trial registry</h4>ClinicalTrials.gov, NCT01230580.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0061949&type=printable |
| spellingShingle | Alan Winston Alejandro Arenas-Pinto Wolfgang Stöhr Martin Fisher Chloe M Orkin Kazeem Aderogba Andrew De Burgh-Thomas Nigel O'Farrell Charles Jn Lacey Clifford Leen David Dunn Nicholas I Paton PIVOT Trial Team Neurocognitive function in HIV infected patients on antiretroviral therapy. PLoS ONE |
| title | Neurocognitive function in HIV infected patients on antiretroviral therapy. |
| title_full | Neurocognitive function in HIV infected patients on antiretroviral therapy. |
| title_fullStr | Neurocognitive function in HIV infected patients on antiretroviral therapy. |
| title_full_unstemmed | Neurocognitive function in HIV infected patients on antiretroviral therapy. |
| title_short | Neurocognitive function in HIV infected patients on antiretroviral therapy. |
| title_sort | neurocognitive function in hiv infected patients on antiretroviral therapy |
| url | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0061949&type=printable |
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