HAART improves subcortical functioning in cognitively impaired HIV patients

Highly active antiretroviral therapy (HAART) improves the mental performance of patients with HIV-related cognitive impairment, but the rate of improvement varies between different cognitive fields.

Dr. Sandra Suarez and colleagues from the Groupe hospitalier Pitie-Salpetriere in Paris assessed the impact of HAART on various cognitive functions in 53 cognitively impaired and 38 non-impaired HIV-infected patients. Subjects were given one to six serial neuropsychological tests and followed for a mean of 12.3 months.

Despite a 25% mortality rate, the cognitively impaired group showed improvements in cognitive functioning that correlated with the duration of HAART, according to a report published in the January 26th issue of AIDS. However, while psychomotor test performance improved steadily with HAART, memory test performance seemed to reach a plateau.

“Psychomotor speed, verbal anterograde memory, and executive functions” improved with HAART, the authors note. “These results reinforce our previous finding that memory impairment in immunocompromised HIV-1-infected patients results from subcorticofrontal dysfunction and also explain why the Mini-Mental State Examination score (reflecting cortical dysfunction) is not improved on HAART.”

The investigators point out that “additional longitudinal surveys are required to determine the long-term impact of HAART on neuropsychological outcome and the possible influence of this action on patients’ quality of life.”