Neuropsychological and neurological function of human immunodeficiency virus seropositive asymptomatic individuals
K. E. Goethe, J. E. Mitchell, D. W. Marshall, R. L. Brey, W. T. Cahill, G. D. Leger, L. J. Hoy and R. N. Boswell
Department of Psychology, Wilford Hall US Air Force Medical Center, Lackland Air Force Base, Tex. 78236-5300.
Although individuals with acquired immunodeficiency syndrome (AIDS) are
often impaired on a variety of neuropsychological tasks, questions remain
as to when neuropsychological decline can be reliably detected during the
course of human immunodeficiency virus (HIV) infection. Detailed
neuropsychological testing was accomplished on a cohort of 83
immunologically and neurologically intact asymptomatic HIV-infected
individuals drawn from a larger pool of 649 US Air Force personnel with HIV
antibodies. These asymptomatic subjects were compared with a group of
HIV-negative subjects, and no significant differences in neuropsychological
functioning were found. No significant neuropsychological differences were
found as a function of cerebrospinal fluid abnormalities in these
asymptomatic subjects. When data from 13 subjects with immune compromise
were included in the analyses, those with abnormal cerebrospinal fluid
values performed significantly poorer on a task of verbal memory,
suggesting that cognitive dysfunction is antedated by immunological
decline. Methodological problems that inhibit specification of the
incidence, prevalence, and natural history of HIV-related cognitive
impairment are discussed, as are data suggesting that previously published
high estimates of the frequency of HIV-related dementia may not be
representative of all HIV-infected populations.
