File(s) not publicly available
The Edinburgh cohort of HIV-positive injecting drug users at 10 years after infection: A case-control study of the evolution of dementia
journal contributionposted on 2021-03-05, 01:11 authored by GM Goodwin, Douglas PretsellDouglas Pretsell, A Chiswick, V Egan, RP Brettle
Objective: To examine the evolution of dementia in HIV-positive injecting drug users (IDU) in Edinburgh. Design: Case-control study. Participants: Twenty six (6%) out of 404 patients in the Edinburgh cohort of HIV-positive IDU who have developed HIV-1-associated dementia in the 10 years since infection and seroconversion. Methods: Patients were tested repeatedly, where possible, on a range of neuropsychological and neurophysiological measures. The results from patients with dementia were compared with those of age, sex and IQ-matched non-demented HIV-positive controls from the cohort. An auditory event-related potential (P3 or P300), a neurophysiological measure of cognitive function, detected the onset of a marked slowing of cognitive and psychomotor functions. Neuropsychological measures that involve the speed of information processing such as the Trail-Making task also identified the early stages of dementia. Results: Dementia was associated with a more advanced stage of systemic disease, increased rates of decline in CD4 cell counts and markedly reduced survival compared with the non-demented controls. No evidence for a protective effect of treatment with zidovudine was detected. Conclusion: In the first 10 years after infection with HIV-1 dementia is an individual development, not the clinical extreme of general intellectual impairment, and had occurred in at least 6% of our IDU cohort. Future questions concern the long-term rate of dementia, the critical neuropathological change and the true potential for early treatment.
PublisherRAPID SCIENCE PUBLISHERS
Rights StatementThe Author reserves all moral rights over the deposited text and must be credited if any re-use occurs. Documents deposited in OPAL are the Open Access versions of outputs published elsewhere. Changes resulting from the publishing process may therefore not be reflected in this document. The final published version may be obtained via the publisher’s DOI. Please note that additional copyright and access restrictions may apply to the published version.
CategoriesNo categories selected
Science & TechnologyLife Sciences & BiomedicineImmunologyInfectious DiseasesVirologyHIV-1AIDSdementiaAIDS dementia complexneuropsychologyauditory event-related potentialHUMAN-IMMUNODEFICIENCY-VIRUSEVENT-RELATED POTENTIALSNEUROPSYCHOLOGICAL FUNCTIONASYMPTOMATIC INDIVIDUALSHOMOSEXUAL MENNERVOUS-SYSTEMFOLLOW-UPCOMPLEXBRAINHumansAIDS Dementia ComplexHIV SeropositivitySubstance Abuse, IntravenousDisease ProgressionZidovudineAntiviral AgentsCD4 Lymphocyte CountCase-Control StudiesCognitionPsychomotor PerformanceNeuropsychological TestsEvoked Potentials, AuditoryAdultFemaleMaleUnited Kingdom