Cerebral function tests reveal differences in HIV-infected subjects with and without chronic HCV co-infection

[Guest guest]

http://www3.interscience.wiley.com/journal/123270635/abstract?CRETRY=1 & SRETRY=0

Clinical Microbiology and Infection

Early View (Articles online in advance of print)

Published Online: 2 Feb 2010

Journal compilation © 2010 European Society of Clinical Microbiology and

Infectious Diseases

ORIGINAL ARTICLE

Cerebral function tests reveal differences in HIV-infected subjects with and

without chronic HCV co-infection

A. Thiyagarajan 1 , L. J. Garvey 1,2 , H. Pflugrad 1 , P. Maruff 3 , G. Scullard

2 , J. Main 1,2 , S. -Robsinson 1 and A. Winston 1,2

1) Division of Medicine, Imperial College, London , 2) Department of HIV and

GU Medicine, Imperial College Healthcare NHS Trust, St 's Hospital, London,

UK and 3) CogState Limited, Melbourne, Australia

Corresponding author and reprint requests: A. Winston, Consultant Physician and

Clinical Senior Lecturer, Imperial College London, London, UK and Clinical

Trials Unit, Ground Floor Winston Churchill Wing, St 's Hospital, Praed

Street W2 1NY, London, UK

E-mail: a.winston@...

Copyright Journal compilation © 2010 European Society of Clinical Microbiology

and Infectious Diseases

ABSTRACT

Neurocognitive impairment (NCI) remains prevalent in HIV-infected subjects

despite effective combination antiretroviral therapy (CART). In subjects without

evidence of hepatic decompensation, NCI is also a feature of chronic HCV

infection. The present study aimed to examine cerebral function and establish

differences between HIV-HCV co-infected (HCVco) and HIV mono-infected (HIVmo)

individuals. Neurologically asymptomatic subjects with chronic HCVco were

eligible and underwent computerized neurocognitive testing (CogState; CogState

Ltd, Melbourne, Australia), a dementia assessment [international HIV Dementia

Scale (IHDS)] and memory assessment [the Prospective and Retrospective Memory

Questionnaire (PRMQ)]. Historic control data were available for 45 HIVmo

individuals and differences between study groups were assessed. Twenty-seven

HCVco subjects were recruited. Plasma HIV RNA was <50 copies/mL in 25/27 of

HCVco subjects and all HIVmo subjects and nadir CD4+ cell count (mean ± SD) was

214 ± 166 cells/ìL and 180 ± 130 cells/ìL, in HCVco and HIVmo subjects,

respectively. No statistically significant differences in neurocognitive

parameters or PRMQ scores were observed between groups. However, a trend towards

poorer executive function score was observed in HCVco subjects (p 0.106). IHDS

score (mean ± SD) was poorer in HCVco subjects (10.48 ± 1.25) vs. HIVmo subjects

(11.51 ± 0.76), (p <0.001). In a multivariate model, increasing age and HCVco

were the only factors significantly associated with poorer IHDS scores (p 0.039

and <0.001, respectively). In HIV-infected subjects stable on CART,

statistically significantly poorer performance in the IHDS score was observed in

subjects with HCVco, although no differences were observed after neurocognitive

testing or memory assessment.

--------------------------------------------------------------------------------

Original Submission: 17 September 2009; Revised Submission: 7 December 2009;

Accepted: 19 January 2010 Editor: J.-M. Pawlotsky

DIGITAL OBJECT IDENTIFIER (DOI)

10.1111/j.1469-0691.2010.03176