HIV DNA and cognition in a Thai longitudinal HAART initiation cohort: the SEARCH 001 Cohort Study.
HIV DNA and cognition in a Thai longitudinal HAART initiation cohort: the SEARCH 001 Cohort Study.
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泰国纵向HAART启动队列中的HIV DNA和认知：搜索001队列研究。
DOI：
10.1212/01.wnl.0000344404.12759.83
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发表时间：
2009-03-17
期刊：
影响因子：
9.9
通讯作者：
Southeast Asia Research Collaboration with the University of Hawaii 001 protocol team
中科院分区：
文献类型：
--
作者：
Valcour VG;Shiramizu BT;Sithinamsuwan P;Nidhinandana S;Ratto-Kim S;Ananworanich J;Siangphoe U;Kim JH;de Souza M;Degruttola V;Paul RH;Shikuma CM;Southeast Asia Research Collaboration with the University of Hawaii 001 protocol team
高活性抗逆转录病毒治疗（HAART）时代的认知障碍在多大程度上是由于活性过程、库清除不完全或合并症引起的，这是有争议的。本研究旨在确定免疫和病毒学因素是否会影响泰国hiv相关痴呆患者（HAD）和泰国非HAD患者（非HAD）首次HAART后的认知。纵向捕获变量以确定首次HAART治疗后认知恢复程度的预测因素。神经心理学数据与230名hiv阴性的泰国对照进行了比较。HIV RNA和CD4淋巴细胞计数不能横断面预测HAD或纵向认知改善程度。相比之下，从单核细胞中分离的基线和纵向HIV DNA与认知能力相关，而不考虑HAART前（p < 0.001）和HAART后48周的血浆HIV RNA和CD4淋巴细胞计数（p < 0.001）。基线水平超过3.5 log10拷贝HIV DNA/106单核细胞区分所有HAD和非HAD病例（p < 0.001）。在48周时，15/15的非HAD患者的单核细胞HIV DNA低于我们的检测水平（10拷贝/106个细胞），而只有4/12的HAD患者，尽管26/27的患者的血浆HIV RNA检测不到。基线单核细胞HIV DNA通过综合评分预测48周的认知表现，独立于并发单核细胞HIV DNA和CD4计数（p < 0.001）。在该队列中，单核细胞HIV DNA水平与高效抗逆转录病毒治疗（HAART）前和HAART治疗后48周的认知表现相关，基线单核细胞HIV DNA可能预测48周的认知表现。这些发现提出了一种可能性，即HAART治疗的短期不完全认知恢复可能代表了与这一外周储层相关的活跃过程。
The extent to which highly active antiretroviral therapy (HAART) era cognitive disorders are due to active processes, incomplete clearance of reservoirs, or comorbidities is controversial. This study aimed to determine if immunologic and virologic factors influence cognition after first-time HAART in Thai individuals with HIV-associated dementia (HAD) and Thai individuals without HAD (non-HAD). Variables were captured longitudinally to determine factors predictive of degree of cognitive recovery after first-time HAART. Neuropsychological data were compared to those of 230 HIV-negative Thai controls. HIV RNA and CD4 lymphocyte counts were not predictive of HAD cross-sectionally or degree of cognitive improvement longitudinally. In contrast, baseline and longitudinal HIV DNA isolated from monocytes correlated to cognitive performance irrespective of plasma HIV RNA and CD4 lymphocyte counts pre-HAART (p < 0.001) and at 48 weeks post HAART (p < 0.001). Levels exceeding 3.5 log10 copies HIV DNA/106 monocyte at baseline distinguished all HAD and non-HAD cases (p < 0.001). At 48 weeks, monocyte HIV DNA was below the level of detection of our assay (10 copies/106 cells) in 15/15 non-HAD compared to only 4/12 HAD cases, despite undetectable plasma HIV RNA in 26/27 cases. Baseline monocyte HIV DNA predicted 48-week cognitive performance on a composite score, independently of concurrent monocyte HIV DNA and CD4 count (p < 0.001). Monocyte HIV DNA level correlates to cognitive performance before highly active antiretroviral therapy (HAART) and 48 weeks after HAART in this cohort and baseline monocyte HIV DNA may predict 48-week cognitive performance. These findings raise the possibility that short-term incomplete cognitive recovery with HAART may represent an active process related to this peripheral reservoir.
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影响因子：
158.5
作者：
SCHMITT, FA;BIGLEY, JW;DRUCKER, JL
通讯作者：
DRUCKER, JL
影响因子：
3.7
作者：
PELUSO, R;HAASE, A;VENTURA, P
通讯作者：
VENTURA, P
影响因子：
10.5
作者：
MAJ, M;JANSSEN, R;SARTORIUS, N
通讯作者：
SARTORIUS, N
影响因子：
3.8
作者：
Robertson, Kevin R.;Smurzynski, Marlene;Ellis, Ron J.
通讯作者：
Ellis, Ron J.
影响因子：
3.2
作者：
Lane, JH;Sasseville, VG;Lackner, AA
通讯作者：
Lackner, AA