Effects of highly active antiretroviral therapy on cognitive functions in severely immune-compromised HIV-seropositive patients

Objective: This study assessed the effects of highly active antiretroviral therapy on the cognitive performances of HIV seropositive patients with severe immune depression. Methods: It is a prospective longitudinal interventional study of 69 anti-retroviral nave HIV-seropositive adult patients with CD4 levels <= 350/mu l. The cognitive assessment was done at initiation and 12 months after anti-retroviral treatment using the Community Screening Instrument for Dementia (CSID) and the computer-assisted Iron Psychology (FePsy). The impact of therapy on CD4 levels and cognitive scores of the patients before and after therapy were compared and tested for statistical significance using Student t test and one-way ANOVA. Results: The mean age of the patients was 36.6 +/- 8.8 years. There was a significant increase in CD4 levels of the patients from 144.75 +/- 88.92 at baseline to 295.91 +/- 148.79 after 12 months of HAART (p<0.0001). There were significant improvements in their cognitive scores (p<0.05) in all cognitive domains tested but the finger tapping task (motor speed) did not show any improvement (p>0.05). Combination ARV drugs with efavirenz did not significantly improve attention and choice reaction time. Conclusion: Highly active antiretroviral therapy significantly improved the CD4 levels and cognitive performances of treated HIV positive patients in all tested domains with the exception of motor speed. (C) 2011 Elsevier B.V. All rights reserved.