CHARTER results: Neurocognitive impairment common among patients with HIV

MONTREAL — A high prevalence of neurocognitive impairment is still seen among patients with HIV, even among those who received combination antiretroviral treatment, according to results of the CHARTER study, presented at the 16th Annual Conference on Retroviruses and Opportunistic Infections, held here.

The results also demonstrated that substantial neurocognitive impairment was common even among patients with no significant comorbidities.

Igor Grant, MD, from the University of California, San Diego, presented the results. Grant said that about 40% to 50% of patients with HIV who are receiving appropriate treatment will experience some neurocognitive impairments. “These may vary from small impairments that the patient may not even recognize to ones that would impact day-to-day life,” Grant said.

Grant and his colleagues conducted neuropsychological evaluations on 1,555 patients with HIV at six university clinics in the United States. The average age of the patients was 43.2 years; 77% were male. There were no neuromedical or psychiatric exclusions for participation in the study. Patients were classified in to one of three categories according to severity of their comorbidities: minimal, moderate and severe.

The results indicated that 45% of patients demonstrated some form of neurocognitive impairment. Patients with more significant comorbidities were more likely to have neurocognitive impairments. Neurocognitive impairments were seen in 39% of patients with minimal comorbidities, 54% of patients with moderate comorbidities and 79% of patients with severe comorbidities.

Grant said these results reiterate the need for more studies to determine if ART-related HIV suppression may protect the central nervous system more effectively if started earlier. – by Jay Lewis

For more information:

Grant I. #154. Presented at: the 16th Annual Conference on Retroviruses and Opportunistic Infections; Feb. 8-11, 2009; Montreal.