Cognitive impairment and antiretroviral treatment in a Peruvian population of patients with human immunodeficiency virus

Abstract

Background: HIV-associated cognitive impairment occurs even in the early stages of infection. Short-term memory, psychomotor speed, attention, and executive functioning are the main capacities affected. Controversy exists regarding whether highly active antiretroviral therapy (HAART) is helpful in combating this process. The objective of the present study is to determine the association between cognitive impairment and HAART in HIV-infected patients from Hospital Regional de Huacho.

Methods: Prospective study of HIV patients meeting criteria to start HAART. Twenty-one HIV-positive patients were recruited between April and July 2011. Researchers administered a standardised neuropsychological test battery before and 4 weeks after onset of HAART. Psychomotor speed, executive function, short term memory (visual and verbal), attention, and visuospatial performance were evaluated.

Results: Nineteen patients completed the study (14 males and 5 females). In the pre-HAART evaluation, most patients scored below average on the executive function and psychomotor speed subtests. Psychomotor speed and immediate visual memory improved significantly after four months of treatment with HAART.

Conclusions: Some degree of cognitive decline may present even in the early and asymptomatic stages of HIV infection. The benefits of antiretroviral treatment for cognitive performance can be detected after only a few weeks of follow-up.

Keywords: Cognitive impairment; Cognitive profile; Deterioro cognitivo; Highly active antiretroviral therapy; Human immunodeficiency virus; Neuropsychological test; Perfil cognitivo; Terapia antirretroviral de gran actividad; Test neuropsicológico; Virus de la inmunodeficiencia humana.