Cognitive disorders in HIV-infected patients: are they HIV-related?

Fabrice Bonnet, Hélène Amieva, Fabienne Marquant, Charlotte Bernard, Mathias Bruyand, Frédéric-Antoine Dauchy, Patrick Mercié, Carine Greib, Laura Richert, Didier Neau, Gwenaelle Catheline, Patrick Dehail, Francois Dabis, Philippe Morlat, Jean-François Dartigues, Geneviève Chêne
AIDS. 2013-01-01; 27(3): 391-400
DOI: 10.1097/qad.0b013e32835b1019

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1. AIDS. 2013 Jan 28;27(3):391-400. doi: 10.1097/QAD.0b013e32835b1019.

Cognitive disorders in HIV-infected patients: are they HIV-related?

Bonnet F(1), Amieva H, Marquant F, Bernard C, Bruyand M, Dauchy FA, Mercié P,
Greib C, Richert L, Neau D, Catheline G, Dehail P, Dabis F, Morlat P, Dartigues
JF, Chêne G; S CO3 Aquitaine Cohort.

Collaborators: Dabis F, Bruyand M, Chêne G, Dabis F, Lawson-Ayayi S, Thiébaut R,
Bonnal F, Bonnet F, Bernard N, Caunègre L, Cazanave C, Ceccaldi J, Chambon D,
Chossat I, Courtaud K, Dauchy FA, De Witte S, Dupon M, Dupont A, Duffau P,
Dutronc H, Farbos S, Gaborieau V, Gemain MC, Gerard Y, Greib C, Hessamfar M,
Lacoste D, Lataste P, Lafarie S, Lazaro E, Longy-Boursier M, Malvy D, Meraud JP,
Mercié P, Monlun E, Morlat P, Neau D, Ochoa A, Pellegrin JL, Pistone T, Ragnaud
JM, Receveur MC, Tchamgoué S, Vandenhende MA, Viallard JF, Moreau JF, Pellegrin
I, Fleury H, Lafon ME, Masquelier B, Trimoulet P, Breilh D, Haramburu F,
Miremont-Salamé G, Blaizeau MJ, Decoin M, Delaune J, Delveaux S, D’Ivernois C,
Hanapier C, Leleux O, Uwamaliya-Nziyumvira B, Sicard X, Geffard S, Palmer G,
Touchard D, Bonnet F, Chêne G, Dupon F, Fleury H, Lacoste D, Malvy D, Mercié P,
Moreau JF, Morlat P, Neau D, Pellegrin JL, Ragnaud JM, Thiébaut R.

Author information:
(1)Service de Médecine Interne et Maladies Infectieuses, Hôpital Saint-André ,
CHU Bordeaux, 1 rue Jean Burguet, 33075 Bordeaux cedex, France.

OBJECTIVES: Large unselected studies on representative samples of HIV-infected
patients with a whole battery of neuropsychological tests and cerebral MRI scan
are required to assess the frequency of neurocognitive impairment (NCI), the
determinants of mild neurocognitive disorders (MNDs), or HIV-associated dementia
(HAD) and the relationship between NCI and MRI scan findings.
METHODS: Investigation of 400 consecutively enrolled HIV-1-infected adults from
the ANRS CO3 Aquitaine Cohort, using standardized neurocognitive tests chosen to
achieve consistency with Frascati’s criteria. Half of the patients had a cerebral
MRI scan allowing gray and white matter volume measurement. Factors associated
with NCI were studied by logistic regression models.
RESULTS: Median age of participants was 47 years, 79% were male and 89% received
combination antiretroviral treatment (cART), of whom 93% had plasma HIV RNA below
500 copies/ml. Median CD4 cell count was 515 cells/μl. Prevalence of NCI was 59%,
including 21% of asymptomatic NCI, 31% of MND, and 7% of HAD. A low level of
education, prior neurologic AIDS-defining disorders event, anxiety, depressive
symptoms, and prior history of brain damage were independently associated with
MND or HAD, but neither HIV nor cART-related variables. The presence of NCI was
significantly associated with lower gray matter fraction.
INTERPRETATION: In this large unselected cohort, a high prevalence of symptomatic
neurocognitive disorders was mainly related to its traditional determinants and
associated with gray matter atrophy at early stages of the disease.

DOI: 10.1097/QAD.0b013e32835b1019
PMID: 23079813 [Indexed for MEDLINE]

Auteurs Bordeaux Neurocampus