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The effects of antiretroviral treatment initiation on cognition in HIV-infected individuals with advanced disease in Pune, India

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Abstract

There has been a reduction in the most severe cases of HIV-associated neurocognitive disorders (HAND) with advances in antiretroviral treatment (ART). But the prevalence of milder forms of HAND still remains high. Data from systematically conducted studies on the effects of ART on cognition are scanty in India, where HIV-1 clade C is prevalent. The purpose of the present study was to assess the effect of antiretroviral therapy in HIV-seropositive (HIV+) individuals (n = 92) with CD4 cell counts <200 cells/mm3. The overall and domain-specific levels of cognitive functioning were determined using a locally recruited normative sample, and a change in neurocognitive functioning at the 1-year follow-up visit was analyzed. Results revealed cognitive impairment in 44.6 % of the HIV+ group at baseline. At the 1-year follow-up, the group showed significant improvement in the Learning domain (p < 0.05). HIV+ individuals showing improvement in the global cognitive scores had a significantly lower baseline CD4 cell count compared to others. Overall, the degree of improvement associated with the magnitude of rise in CD4 suggests the possibility that early, mild subclinical deficits may also benefit from treatment.

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Acknowledgments

This research was supported by the National Institute of Mental Health (NIMH) R01 MH78748 NeuroAIDS in India (Dr. Marcotte, P.I.) and P30 MH62512 HIV Neurobehavioral Research Center (Dr. Grant, P.I.).

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. National AIDS Research Institute, Post Box 1895, G-73, MIDC, Bhosari, Pune, Maharashtra, 411026, India

    Manisha Ghate, Madhuri Thakar, Arun Risbud & Smita Kulkarni

  2. National Institute of Epidemiology, Chennai, India

    Sanjay Mehendale

  3. HIV Neurobehavioral Research Program, University of California, San Diego, CA, USA

    Rachel Meyer, Anya Umlauf, Reena Deutsch, Rujvi Kamat, Maiko Sakamoto, Terry Alexander, Donald Franklin, Scott Letendre, Robert K. Heaton, Igor Grant & Thomas D. Marcotte

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  1. Manisha Ghate
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Correspondence to Manisha Ghate.

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Ghate, M., Mehendale, S., Meyer, R. et al. The effects of antiretroviral treatment initiation on cognition in HIV-infected individuals with advanced disease in Pune, India. J. Neurovirol. 21, 391–398 (2015). https://doi.org/10.1007/s13365-015-0329-z

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  • DOI: https://doi.org/10.1007/s13365-015-0329-z

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