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Changes in CSF and plasma HIV-1 RNA and cognition after starting potent antiretroviral therapy

From the Departments of Neurology (Drs. Marra and Zunt), Medicine (Infectious Diseases) (Drs. Marra, Coombs, and Collier, and M. Perrin), and Laboratory Medicine (Dr. Coombs), School of Medicine, and Department of Biostatistics (D. Lockhart), School of Public Health, University of Washington, Seattle.

Address correspondence and reprint requests to Dr. Christina M. Marra, Harborview Medical Center, Neurology, Box 359775, 325 9th Avenue, Seattle, WA 98104; e-mail: cmarra{at}u.washington.edu

The authors assessed CSF and plasma HIV-1 RNA and neuropsychological test performance (composite neuropsychological test Z score [NPZ-4]) in 25 HIV-1–infected subjects 4 and 8 weeks after beginning potent antiretroviral therapy that included a protease inhibitor. In the 14 subjects who entered the study on no antiretroviral treatment, NPZ-4 improvement was associated with decline in CSF HIV-1 RNA at both visits (p = 0.001 and p = 0.02), and those treated with zidovudine or indinavir had greater improvement in NPZ-4 at both visits compared to those treated with other drugs (p = 0.003 and p = 0.01).

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