艾滋病病毒感染者和弓形虫脑炎或潜伏弓形虫感染者认知功能的纵向研究。

IF 3.4 2区 医学 Q3 IMMUNOLOGY AIDS Pub Date : 2024-08-09 DOI:10.1097/QAD.0000000000003992
Monica M Diaz, J Allen Mccutchan, Melanie Crescini, Bin Tang, Donald Franklin, Scott L Letendre, Robert K Heaton, Ajay R Bharti
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引用次数: 0

摘要

背景:神经认知障碍(NCI)可能会在与艾滋病毒相关的中枢神经系统合并感染(如弓形体脑炎(TE))期间出现,甚至在康复后仍然存在。目前尚不清楚弓形体脑炎(TE)和潜伏弓形体感染(LTI)对艾滋病病毒感染者(PWH)认知能力的长期影响。与LTI或未感染弓形虫相比,我们测量了TE对PWH数控功能的纵向影响:在两项纵向队列研究中跟踪的感染者(n = 345)接受了全面的神经认知评估和抗弓形虫 IgG 检测。参与者被分为三组:TE+ 组(39 人)、LTI+ 组(34 人)、LTI- 组(272 人)。主要结果是基线和7年访视之间神经认知功能的变化:平均年龄(48 ± 11)岁,平均受教育程度(13 ± 3)年,13%为女性。TE+患者检测不到病毒载量(≤50拷贝/毫升)的可能性较低,CD4绝对计数也较低。在基线和7年随访中,TE+组的NCI发病率在全球最高,在言语、执行功能、学习、回忆、工作记忆、处理速度和运动等领域的发病率也最高。7年间,纵向NC功能的变化较小,各组之间没有显著差异,但TE+组与LTI-组相比,信息处理速度的改善幅度更大:结论:有 TE 病史的威尔士人在基线和最后一次随访中都出现了严重程度不等的认知障碍。从基线到最后一次检查,所有组别的认知能力变化都很小,除信息处理速度外,各组之间没有显著差异。
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Longitudinal Study of Cognitive Function in People with HIV and Toxoplasmic Encephalitis or Latent toxoplasma Infection.

Background: Neurocognitive impairment (NCI) may occur during and persist even after recovery from HIV-related CNS co-infections such as toxoplasmic encephalitis (TE). The long-term cognitive effects of TE and latent toxoplomasmic infections (LTI) among persons with HIV (PWH) are unknown. We measured longitudinal effects on NC functioning in PWH with TE compared to LTI or no toxoplasmal infection.

Methods: PWH (n = 345) followed in two longitudinal cohort studies underwent comprehensive neurocognitive assessments and an anti-Toxoplamic IgG assay. Participants were classified into one of three groups: TE+ (n = 39), LTI+ (n = 34), LTI- (n = 272). The primary outcome was change in neurocognitive function between baseline and 7-year visit.

Results: The mean age was 48 ± 11 years, mean educational level 13 ± 3 years, and 13% were female. TE+ patients were less likely to have undetectable viral loads (≤50 copies/mL) and had lower absolute CD4 counts. The TE+ group had the highest prevalence of NCI globally and in domains of verbal, executive function, learning, recall, working memory, processing speed and motor at baseline and at 7-year follow-up. Changes in longitudinal NC function over 7 years were small and did not differ significantly among all groups, except that speed of information processing improved more in TE+ compared with LTI- participants.

Conclusions: PWH with a history of TE had cognitive impairment over a broad range of severity at both baseline and last follow-up. Changes in cognition from baseline to last examination in all groups were minimal and did not differ significantly among the groups with the exception of speed of information processing.

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来源期刊
AIDS
AIDS 医学-病毒学
CiteScore
5.90
自引率
5.30%
发文量
478
审稿时长
3 months
期刊介绍: ​​​​​​​​​​​​​​​​​Publishing the very latest ground breaking research on HIV and AIDS. Read by all the top clinicians and researchers, AIDS has the highest impact of all AIDS-related journals. With 18 issues per year, AIDS guarantees the authoritative presentation of significant advances. The Editors, themselves noted international experts who know the demands of your work, are committed to making AIDS the most distinguished and innovative journal in the field. Submitted articles undergo a preliminary review by the editor. Some articles may be returned to authors without further consideration. Those being considered for publication will undergo further assessment and peer-review by the editors and those invited to do so from a reviewer pool.
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