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Richard S. Beach, MD, PhD; Robert Morgan, PhD; Frances Wilkie, PhD; Emilio Mantero-Atienza, MD, PhD; Nancy Blaney, PhD; Gail Shor-Posner, PhD; Ying Lu, PhD; Carl Eisdorfer, MD, PhD; Marianna K. Baum, PhD

Arch Neurol. 1992;49(5):501-506.

Abstract
• Studies of cognitive function in subjects with human immunodeficiency virus type 1 (HIV-1) infection who remain relatively asymptomatic (ie, Centers for Disease Control stages II and III) have provided widely variable estimates of cognitive impairment. In view of the finding that approximately 25% of asymptomatic HIV-1—infected subjects demonstrate either marginal or overt vitamin B₁₂ deficiency, we have investigated plasma vitamin B₁₂ status as a potential cofactor in studies of HIV-1—related cognitive impairment. When cognition was assessed in asymptomatic (Centers for Disease Control stages II and III) HIV-1—infected participants taking into consideration vitamin B₁₂ status, those subjects with low plasma vitamin B₁₂ levels (<180 pmol/L) performed more poorly than did those with normal (180 pmol/L) vitamin B₁₂ status on specific measures of information processing speed and visuospatial problem-solving skills. These findings suggest that concurrent vitamin B12 deficiency may be a cofactor in subtle cognitive changes observed in the asymptomatic stages of HIV-1 infection. These differences in prevalence of low plasma vitamin B₁₂ levels may help to explain differences among studies in the proportion of HIV-1—infected subjects showing cognitive impairment.

Author Affiliations
From the Department of Epidemiology and Public Health (Drs Beach, Morgan, Mantero-Atienza, Shor-Posner, Lu, and Baum), the Center for the Biopsychosocial Study of AIDS (Drs Beach, Morgan, Wilkie, Mantero-Atienza, Blaney, Shor-Posner, Lu, Eisdorfer, and Baum), and the Division of Neonatology (Dr Beach), Broward General Medical Center, Ft Lauderdale, Fla; and the Department of Psychiatry (Drs Mantero-Atienza, Morgan, Wilkie, Blaney, and Eisdorfer), University of Miami (Fla) School of Medicine.

Footnotes
Accepted for publication December 3, 1991.

Reprint requests to Division of Neonatology, Broward General Medical Center, 1600 S Andrews Ave, Fort Lauderdale, FL 33136 (Dr Beach).

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