ABSTRACT
It is known that HIV can directly infect the CNS and, as a result of such infection, neuropsychological alterations with cognitive, behavioural and motor manifestations can be developed. In this study we seek to determine whether seropositivity is associated with a poor neuropsychological performance in patients with a history of intravenous drug consumption (n=90). For this purpose we carried out an extensive neuropsychological evaluation and compared their performance with that of two seronegative control groups, one comprised of subjects with no history of drug abuse (n=22), which allowed us to obtain a reference of normal neuropsychological performance, and the other of seronegative subjects with a history of drug abuse (n=48), which allowed us to differentiate whether the performance of the seropositive subjects derives from their history of drug abuse. The results reveal that HIV infection in drug users is associated with deficits in attention, verbal and visual memory, verbal skills, concept formation and reasoning, visual-constructive skills, manual dexterity, and perceptive-motor speed, which cannot be attributed to a history of drug abuse. However, the seronegative drug users also showed some of these alterations, which suggests that seropositivity is not only associated with a decrease in performance in these tasks, but also adds to the alterations seen in seronegative subjects as a consequence of drug abuse.
Subject(s)
Acquired Immunodeficiency Syndrome/psychology , HIV , Neuropsychological Tests , Substance Abuse, Intravenous/psychology , Acquired Immunodeficiency Syndrome/complications , Acquired Immunodeficiency Syndrome/virology , Adult , Attention , CD4-Positive T-Lymphocytes , Cognition/physiology , HIV Seronegativity , Humans , Intelligence , Male , Psychomotor Performance/physiology , Retention, Psychology , Substance Abuse, Intravenous/complications , Substance Abuse, Intravenous/virology , Trail Making Test , Verbal Learning , Wechsler ScalesABSTRACT
INTRODUCTION: The presence of neuropsychological impairment related to HIV infection has generated abundant literature whose results are disparate. Keeping in mind that it has been suggested that neuropsychological impairment could be associated to the presence of certain factors that would coexist with the own HIV, it is necessary to determine factors which contribute to transform a seropositive into a subject more neuropsychologically vulnerable. DEVELOPMENT: In this work we present a revision of those factors related with HIV infection that can influence neuropsychological performance of the patients as the antecedents of neurological and psychiatric pathology, depressed mood, drugs abuse, and cognitive reserve. CONCLUSIONS: The study of the influence of these factors can not only contribute to clarify the controversy on the presence of neuropsychological deficits, but also to understand why some seropositive patients are more neuropsychologically vulnerable than others, and ultimately to better understand the neuropsychological implications derived of HIV infection.
Subject(s)
HIV Seropositivity/complications , Mental Disorders/etiology , Nervous System Diseases/etiology , Cognition Disorders/etiology , Depression/etiology , Humans , Substance-Related Disorders/complicationsABSTRACT
Introducción. La presencia de alteraciones neuropsicológicas (ANP) asociadas a la infección por VIH ha generado abundante literatura, cuyos resultados son dispares. Si tenemos en cuenta la sugerencia de que la afectación neuropsicológica que pueden llegar a desarrollar los seropositivos podría asociarse a la presencia de determinados factores que coexisten con el propio VIH, se necesita determinar qué factores contribuyen a convertir a un seropositivo en un sujeto más vulnerable neuropsicológicamente. Desarrollo. En este trabajo presentamos una revisión de aquellos factores no relacionados con la infección por VIH que pueden influir en el funcionamiento neuropsicológico de los pacientes, como los antecedentes de patología neurológica y psiquiátrica, el estado de ánimo, el consumo de drogas y la reserva cognitiva. Conclusiones. El estudio de la influencia de estos factores puede contribuir no sólo a clarificar la controversia sobre la presencia de ANP, sino también a comprender porqué algunos pacientes seropositivos son más vulnerables neuropsicológicamente que otros, y, en última instancia, a profundizar y comprender mejor las implicaciones neuropsicológicas derivadas de la infección por el VIH (AU)
Subject(s)
Humans , Nervous System Diseases , Substance-Related Disorders , Mental Disorders , Cognition Disorders , Depression , HIV SeropositivityABSTRACT
There are no definitive risk factors which predict the development of neuropsychological deficits associated to HIV infection, and, taking into account that neuropsychological impairment is a risk factor of early death in all stages of HIV infection, there is a pressing need to determine those factors, either related or foreign to HIV, which help to explain the existing intragroup differences and that may also be associated with the development and progression of the dysfunction. The aim of this work is to revise those factors related with the infection that can influence neuropsychological functioning of the seropositive patients, such as antiretroviral treatments, immunological impairment, viral load and the advance of the infection. Identification of these risk factors will help us to outline characteristics of the seropositive subjects who are neuropsychologically more vulnerable, in order to detect them early with a view to preventing the manifestation of neuropsychological disturbances, and offer quick, suitable treatment.
Subject(s)
Cognition Disorders/etiology , HIV Infections/complications , Neuropsychological Tests , Anti-HIV Agents/therapeutic use , Cognition Disorders/drug therapy , Cognition Disorders/virology , HIV Infections/drug therapy , Humans , Risk FactorsABSTRACT
Todavía no se dispone de factores de riesgo definitivos que indiquen el desarrollo de las alteraciones neuropsicológicas asociadas a la infección por el virus de la inmunodeficiencia humana (VIH) y, teniendo en cuenta que la presencia de trastornos cognitivos constituye un factor de riesgo de muerte precoz en todos los estadios de la infección, urge determinar aquellos factores, extraños o relacionados con el propio VIH, que ayuden a explicar las diferencias intragrupo que existen y que también pueden estar asociadas con el desarrollo y la progresión de la disfunción. En este trabajo planteamos revisar aquellos factores relacionados con la infección que pueden influir en el funcionamiento neuropsicológico de los pacientes seropositivos, como los tratamientos antirretrovirales, el deterioro inmunológico que sufre el paciente, la carga viral y el avance de la infección, considerados factores que pueden influir en el funcionamiento neuropsicológico del seropositivo. El estudio de la influencia de estos factores va a contribuir no sólo a clarificar la controversia sobre la presencia de alteraciones neuropsicológicas, sino también a que podamos perfilar las características de los seropositivos neuropsicológicamente más vulnerables, para detectarlos de manera precoz a efectos de prevenir o paliar las consecuencias de estas alteraciones neuropsicológicas, ofreciéndoles un tratamiento rápido y adecuado. (AU)
