Changes in CSF and plasma HIV-1 RNA and cognition after starting potent antiretroviral therapy

Abstract

The authors assessed CSF and plasma HIV-1 RNA and neuropsychological test performance (composite neuropsychological test Z score [NPZ-4]) in 25 HIV-1-infected subjects 4 and 8 weeks after beginning potent antiretroviral therapy that included a protease inhibitor. In the 14 subjects who entered the study on no antiretroviral treatment, NPZ-4 improvement was associated with decline in CSF HIV-1 RNA at both visits (p = 0.001 and p = 0.02), and those treated with zidovudine or indinavir had greater improvement in NPZ-4 at both visits compared to those treated with other drugs (p = 0.003 and p = 0.01).

Figures

Figure

Mean change in composite neuropsychological test Z score (NPZ-4) (±SE) at each visit adjusted for baseline NPZ-4 among the 14 subjects who entered the study on no antiretroviral agents. The solid line depicts the change in NPZ-4 for subjects who began taking a regimen that included zidovudine (AZT) or indinavir and the dashed line depicts the change in NPZ-4 for subjects who began taking other antiretroviral agents. Change in NPZ-4 is greater at both visits in those subjects who began a regimen that included AZT or indinavir (p = 0.003 at 4 weeks and p = 0.01 at 8 weeks).