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Titolo:
Plasma viral load and CD4 lymphocytes predict HIV-associated dementia and sensory neuropathy
Autore:
Childs, EA; Lyles, RH; Selnes, OA; Chen, B; Miller, EN; Cohen, BA; Becker, JT; Mellors, J; McArthur, JC;
Indirizzi:
Johns Hopkins Univ, Sch Med, Baltimore, MD 21287 USA Johns Hopkins Univ Baltimore MD USA 21287 ch Med, Baltimore, MD 21287 USA Univ Calif Los Angeles, Inst Neuropsychiat, Los Angeles, CA 90024 USA UnivCalif Los Angeles Los Angeles CA USA 90024 Los Angeles, CA 90024 USA Northwestern Univ, Dept Neurol, Chicago, IL 60611 USA Northwestern Univ Chicago IL USA 60611 Dept Neurol, Chicago, IL 60611 USA Univ Pittsburgh, Grad Sch Publ Hlth, Pittsburgh, PA USA Univ Pittsburgh Pittsburgh PA USA Grad Sch Publ Hlth, Pittsburgh, PA USA Univ Pittsburgh, Sch Med, Pittsburgh, PA USA Univ Pittsburgh Pittsburgh PA USA ittsburgh, Sch Med, Pittsburgh, PA USA Johns Hopkins Univ, Sch Hyg & Publ Hlth, Baltimore, MD 21287 USA Johns Hopkins Univ Baltimore MD USA 21287 l Hlth, Baltimore, MD 21287 USA
Titolo Testata:
NEUROLOGY
fascicolo: 3, volume: 52, anno: 1999,
pagine: 607 - 613
SICI:
0028-3878(199902)52:3<607:PVLACL>2.0.ZU;2-G
Fonte:
ISI
Lingua:
ENG
Soggetto:
HUMAN-IMMUNODEFICIENCY-VIRUS; MULTICENTER AIDS COHORT; TYPE-1 RNA LEVELS; CEREBROSPINAL-FLUID; INFECTION; INDIVIDUALS; SERUM; ANTIBODY; THERAPY; ANTIGEN;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
34
Recensione:
Indirizzi per estratti:
Indirizzo: McArthur, JC Johns Hopkins Hosp, 600 N Wolfe St,Meyer 6-109, Baltimore, MD21287 USA Johns Hopkins Hosp 600 N Wolfe St,Meyer 6-109 Baltimore MD USA 21287
Citazione:
E.A. Childs et al., "Plasma viral load and CD4 lymphocytes predict HIV-associated dementia and sensory neuropathy", NEUROLOGY, 52(3), 1999, pp. 607-613

Abstract

Objective: To determine the predictive value of plasma HIV RNA and CD4 lymphocytes for HIV-associated dementia and sensory neuropathy. Methods: A total of 1,604 AIDS-free HIV seropositive men from the Multicenter AIDS CohortStudy were followed over a 10-year period (1985 to 1995). HIV-associated dementia and sensory neuropathy were diagnosed according to standard definitions. Baseline samples were used to measure plasma HIV RNA levels with a branched DNA assay and levels of beta(2)-microglobulin, CD4 lymphocyte counts, and hemoglobin levels. Results: Seventy-seven patients with HIV-associated dementia and 213 patients with sensory neuropathy were identified. Baseline HIV RNA levels above 3,000 copies/mL and CD4 counts below 500 cells/mm(3) were predictive of both neurologic outcomes, but neither hemoglobin, bodymass index, nor beta(2)-microglobulin were independently predictive. Afteradjusting for age and level of education, individuals with baseline plasmaHIV RNA >30,000 copies/mL had a relative hazard for dementia 8.5 times (p < 0.001) that of those with <3,000 copies/mL, and those with CD4 counts <200 cells/mm(3) had a 3.5-fold (p = 0.003) greater hazard relative to those with CD4 counts >500 cells/mm(3). Individuals with HIV RNA >10,000 copies/mLhad a 2.3-fold (p = 0.008) greater hazard of sensory neuropathy than thosewith <500 copies/mL, and men with <750 CD4 cells/mm3 had a 1.4-fold (p = 0.03) greater hazard than those with >750 CD4 cells/mm(3). Conclusions: Highlevels of systemic HIV replication may "drive" the initiation of neurologic disease; effective suppression of HIV may reduce the incidence of dementia and neuropathy. Levels of plasma HIV RNA and CD4 counts, determined before the initiation of antiretroviral therapy, were predictive of HIV-associated dementia and sensory neuropathy.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 30/11/20 alle ore 02:50:02