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学科主题: 精神卫生
题名:
Incidence and nature of cognitive decline over 1 year among HIV-infected former plasma donors in China
作者: Cysique, Lucette A.1,8; Letendre, Scott L.2; Ake, Christopher1; Jin, Hua1,5; Franklin, Donald R.1; Gupta, Saurabh1; Shi, Chuan6; Yu, Xin6; Wu, Zunyou7; Abramson, Ian S.3,4; Grant, Igor1; Heaton, Robert K.1; HIV Neurobehav Res Ctr Grp
关键词: antiretroviral therapy ; China ; highly active ; HIV/AIDS ; incidence studies ; longitudinal studies ; neurocognitive disorders ; neuropsychological tests
刊名: AIDS
发表日期: 2010-04-24
DOI: 10.1097/QAD.0b013e32833336c8
卷: 24, 期:7, 页:983-990
收录类别: SCI ; SSCI
文章类型: Article
WOS标题词: Science & Technology
类目[WOS]: Immunology ; Infectious Diseases ; Virology
研究领域[WOS]: Immunology ; Infectious Diseases ; Virology
关键词[WOS]: COMBINATION ANTIRETROVIRAL THERAPY ; CENTRAL-NERVOUS-SYSTEM ; NEUROPSYCHOLOGICAL IMPAIRMENT ; NEUROCOGNITIVE IMPAIRMENT ; TREATED PATIENTS ; TEST-PERFORMANCE ; RISK-FACTORS ; DEMENTIA ; INDIVIDUALS ; OUTPATIENTS
英文摘要:

Objective: To quantify and characterize the nature of cognitive change over 1 year in a cohort of HIV-positive former plasma donors in rural China.

Design: The present study is an observational cohort study.

Methods: One hundred and ninety-two HIV-positive and 101 demographically comparable HIV-negative individuals, all former plasma donors, who lived in a rural part of China, received comprehensive medical and neuropsychological examinations. At study entry, 56% of HIV-positive group was on combination antiretroviral treatment and 60.9% at follow-up. Multiple regression change score approach was used with the HIV-negative sample to develop norms for change that would be then applied to the HIV-positive participants. Follow-up test scores adjusted for the control group practice effect.

Results: Fifty-three HIV-positive individuals (27%) developed significant cognitive decline as compared with five (5%) HIV-negative individuals. Cognitive decline was predicted at baseline by AIDS status, lower nadir CD4, and worse processing speed; at follow-up, it was associated with lower current CD4 cell count and failure of viral suppression on combination antiretroviral treatment. Neuropsychological decline also was associated with decreased independence in activities of daily living. Using neuropsychological impairment scores that were corrected for ′practice′ on repeated testing, we found that among the decliners, 41.5% (N = 22) had incident impairment, whereas 38% (N = 20) declined within the impaired range and another 20.7% (N = 11) declined within the normal range.

Conclusion: The present study demonstrates that despite ongoing combination antiretroviral treatment, cognitive decline in HIV-positive people is common over a 1-year follow-up. Regression-based norms for change on western neuropsychological tests can be used to detect disease-related cognitive decline in a developing country. (C) 2010 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins

语种: 英语
所属项目编号: 5 R01 MH073433-04 ; MH62512
项目资助者: NIMH ; NIMH
WOS记录号: WOS:000276567500006
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/67919
Appears in Collections:北京大学精神卫生研究所_期刊论文

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作者单位: 1.VA San Diego Healthcare Syst, San Diego, CA USA
2.Peking Univ, Inst Mental Hlth, Beijing 100871, Peoples R China
3.Univ Calif San Diego, Dept Psychiat, La Jolla, CA 92093 USA
4.Univ Calif San Diego, Dept Med, La Jolla, CA 92093 USA
5.Univ Calif San Diego, Dept Math, La Jolla, CA 92093 USA
6.Univ Calif San Diego, HNRC, La Jolla, CA 92093 USA
7.Natl Ctr AIDS STD Control & Prevent NCAIDS, Beijing, Peoples R China
8.Univ New S Wales, Dept Psychiat, Sydney, NSW, Australia

Recommended Citation:
Cysique, Lucette A.,Letendre, Scott L.,Ake, Christopher,et al. Incidence and nature of cognitive decline over 1 year among HIV-infected former plasma donors in China[J]. AIDS,2010,24(7):983-990.
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