Journal of the International Neuropsychological Society

Research Articles

The HNRC 500-Neuropsychology of Hiv infection at different disease stages

Robert K. Heatona1, Igor Granta1a2, Nelson Buttersa1a2, Desireé A. Whitea1, Donald Kirsona1, J. Hampton Atkinsona1, J. Allen McCutchana1, Michael J. Taylora1, Mark D. Kellya1, Ronald J. Ellisa1a2, Tanya Wolfsona1, Robert Velina1, Thomas D. Marcottea1, John R. Hesselinka1a2, Terry L. Jernigana1a2, James Chandlera3, Mark Wallacea3, Ian Abramsona1 and THE HNRC GROUPa1a2a3

a1 University of California at San Diego, Dept. of Psychiatry, La Jolla, CA 92093

a2 Veterans Affairs Medical Center-San Diego, La Jolla, CA 92161

a3 U.S. Naval Medical Center-San Diego, CA, 92134

Abstract

The present study examined neuropsychological (NP) functioning and associated medical, neurological, brain magnetic resonance imaging (MRI), and psychiatric findings in 389 nondemented males infected with Human Immunodeficiency Virus-Type 1 (HIV-1), and in 111 uninfected controls. Using a comprehensive NP test battery, we found increased rates of impairment at each successive stage of HIV infection. HIV-related NP impairment was generally mild, especially in the medically asymptomatic stage of infection, and most often affected attention, speed of information processing, and learning efficiency; this pattern is consistent with earliest involvement of subcortical or frontostriatal brain systems. NP impairment could not be explained on the bases of mood disturbance, recreational drug or alcohol use, or constitutional symptoms; by contrast, impairment in HIV-infected subjects was related to central brain atrophy on MRI, as well as to evidence of cellular immune activation and neurological abnormalities linked to the central nervous system. (JINS, 1995, 1, 231–251.)

(Received November 17 1994)

(Accepted December 20 1994)

Footnotes

The authors of this study arc members of the San Diego HIV Neu robehavioral Research Center (HNRC).

Alex Martin served as action editor in the review of the manuscript for this article.

Reprint requests to: Robert K. Heaton, University of California at San Diego, Department of Psychiatry, 3427 4th Avenue-Room 216, San Diego, CA, 92103.