Is There Evidence for Neurocognitive Dysfunctions in Patients with Postnatal HIV Infection? A Review on the Cohort of Hemophilia Patients.

Silvia Riva,Gabriella Pravettoni,Ilaria Cutica

doi:10.3389/fnhum.2014.00470

Silvia Riva, Gabriella Pravettoni + Show 1 more

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https://doi.org/10.3389/fnhum.2014.00470

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Abstract

The debate regarding neurocognitive functions in the early stages of HIV infection is still ongoing; different studies have reached contrasting conclusions, probably because many of them take into account different cohorts of patients. A main distinction is between HIV seropositive patients infected perinatally, and those infected postnatally. The aim of this paper is to review results on neurocognitive dysfunctions and other types of neurological involvement in a specific cohort of HIV+ patients infected postnatally: hemophilia patients. Such a review is relevant, as HIV seropositive patients infected postnatally are understudied with respect to patients infected perinatally, and as the results of the few studies aiming at comparing them are contrasting. Taken together, the 11 studies reviewed suggest the presence of both long-term neurocognitive dysfunctions and neurological alterations, such as the presence of atrophic changes and lesions in the white matter. The current review may offer new research insights into the neurocognitive dysfunctions in HIV-patients, and on the nature of such dysfunctions.

Highlights

HIV infection is associated with a variety of neurocognitive dysfunctions, which may occur at each stage of infection, and which progress during the course of the illness, such progression may vary depending on therapies
Before the introduction of highly active antiretroviral therapy (HAART), neurocognitive dysfunctions represented a frequent outcome in about 60% of patients (Reger et al, 2002; Ettenhofer et al, 2009)
Findings across the HIV literature are not entirely consistent, a number of studies show that HIV-infected patients present deficits in speed of information processing (Carey et al, 2006; Giesbrecht et al, 2014), in fine motor speed (Sacktor et al, 2002) in learning and memory (Carey et al, 2006; Maki et al, 2009), in attention (Giesbrecht et al, 2014), and in multiple domains of executive functioning such as cognitive flexibility, decision-making, and planning (Iudicello et al, 2008; Cattie et al, 2012)

Summary

Introduction

HIV infection is associated with a variety of neurocognitive dysfunctions, which may occur at each stage of infection, and which progress during the course of the illness, such progression may vary depending on therapies. Before the introduction of highly active antiretroviral therapy (HAART), neurocognitive dysfunctions represented a frequent outcome in about 60% of patients (Reger et al, 2002; Ettenhofer et al, 2009). Notwithstanding, several studies have highlighted difficulties in neurocognitive performance at different levels (York et al, 2001; Sacktor et al, 2002; Carey et al, 2006; Iudicello et al, 2008; Woods et al, 2008; Cattie et al, 2012; Giesbrecht et al, 2014) in HIV seropositive (HIV+) patients; some authors have argued that such difficulties might be more related to the presence of important covariates, such as drug abuse, cranial traumas, and several psychological alterations rather than to the direct action of HIV virus. Findings across the HIV literature are not entirely consistent, a number of studies show that HIV-infected patients present deficits in speed of information processing (Carey et al, 2006; Giesbrecht et al, 2014), in fine motor speed (Sacktor et al, 2002) in learning and memory (Carey et al, 2006; Maki et al, 2009), in attention (Giesbrecht et al, 2014), and in multiple domains of executive functioning such as cognitive flexibility, decision-making, and planning (Iudicello et al, 2008; Cattie et al, 2012)

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