TY - JOUR
T1 - Combination antiretroviral therapy improves psychomotor speed performance in HIV-seropositive homosexual men
AU - Sacktor, N. C.
AU - Lyles, R. H.
AU - Skolasky, R. L.
AU - Anderson, D. E.
AU - McArthur, J. C.
AU - McFarlane, G.
AU - Seines, O. A.
AU - Becker, J. T.
AU - Cohen, B.
AU - Wesch, J.
AU - Miller, E. N.
PY - 1999/5/12
Y1 - 1999/5/12
N2 - Background: Combination antiretroviral therapy including protease inhibitors (combo+PI) is effective in suppressing systemic vital load in HIV infection, but its impact on HIV-associated cognitive impairment is unclear. Objective: To determine whether psychomotor speed, a sensitive measure of impairment in HIV dementia, improves with combo+PI compared with other antiretroviral treatments. Methods: A total of 411 HIV-seropositive (HIV+) homosexual men (with longitudinal neuropsychological testing) in the Multicenter AIDS Cohort Study and, in a separate analysis, 282 HIV+ homosexual men with psychomotor slowing at baseline were classified by treatment into four groups: antiretroviral naive (no antiretroviral medication treatment), monotherapy, combination antiretroviral therapy without protease inhibitors (combo-noPI), and combo+PI. We compared longitudinal performance on three tests of psychomotor speed: the Grooved Pegboard (GP) (nondominant and dominant hands), Trail Making Test B, and the Symbol Digit Modalities Test (SDMT). Results: Relative to antiretroviral- naive and monotherapy participants, on the GP nondominant hand test, combo+PI participants with abnormal baseline neuropsychological testing showed improved performance (difference = +0.63 standard deviation [SD], p = 0.02). For the SDMT, both combo+PI participants (difference = +0.26 SD, p = 0.03) and combo-noPI participants (difference = +0.29 SD, p = 0.01) with abnormal baseline neuropsychological testing improved compared with antiretroviral- naive and monotherapy groups. Conclusion: Combo+PI and combo-noPI are associated with improved psychomotor speed performance in HIV+ homosexual men with abnormal neuropsychological testing.
AB - Background: Combination antiretroviral therapy including protease inhibitors (combo+PI) is effective in suppressing systemic vital load in HIV infection, but its impact on HIV-associated cognitive impairment is unclear. Objective: To determine whether psychomotor speed, a sensitive measure of impairment in HIV dementia, improves with combo+PI compared with other antiretroviral treatments. Methods: A total of 411 HIV-seropositive (HIV+) homosexual men (with longitudinal neuropsychological testing) in the Multicenter AIDS Cohort Study and, in a separate analysis, 282 HIV+ homosexual men with psychomotor slowing at baseline were classified by treatment into four groups: antiretroviral naive (no antiretroviral medication treatment), monotherapy, combination antiretroviral therapy without protease inhibitors (combo-noPI), and combo+PI. We compared longitudinal performance on three tests of psychomotor speed: the Grooved Pegboard (GP) (nondominant and dominant hands), Trail Making Test B, and the Symbol Digit Modalities Test (SDMT). Results: Relative to antiretroviral- naive and monotherapy participants, on the GP nondominant hand test, combo+PI participants with abnormal baseline neuropsychological testing showed improved performance (difference = +0.63 standard deviation [SD], p = 0.02). For the SDMT, both combo+PI participants (difference = +0.26 SD, p = 0.03) and combo-noPI participants (difference = +0.29 SD, p = 0.01) with abnormal baseline neuropsychological testing improved compared with antiretroviral- naive and monotherapy groups. Conclusion: Combo+PI and combo-noPI are associated with improved psychomotor speed performance in HIV+ homosexual men with abnormal neuropsychological testing.
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U2 - 10.1212/wnl.52.8.1640
DO - 10.1212/wnl.52.8.1640
M3 - Article
C2 - 10331692
AN - SCOPUS:0033549114
SN - 0028-3878
VL - 52
SP - 1640
EP - 1647
JO - Neurology
JF - Neurology
IS - 8
ER -
