Neurocognitive Assessment in Youth Initiating HAART

A prospective cohort study comparing neurocognitive functioning in four groups of youth, ages 18-24 years, with behaviorally acquired HIV infection: two groups with CD4+ T-cells greater than 350 cells/mm3 and HIV RNA equal to or greater than 1,000 copies/ml - one initiating early highly active antiretroviral therapy (HAART) (Group 1), the other not initiating treatment (Group 2); and two groups with CD4+ T-cells less than 350 cells/mm3 - one initiating HAART according to then current DHHS guidelines (Group 3), the other not initiating treatment (Group 4). Groups 2 and 3 represented standard of care. The study provided preliminary data to test the hypothesis that initiating HAART earlier than DHHS guidelines suggested at that time resulted in better neurocognitive function in comparison with no treatment or treatment initiated according to DHHS recommendations.

本项前瞻性队列研究针对4组18至24岁经行为途径获得人类免疫缺陷病毒（Human Immunodeficiency Virus，HIV）感染的青年，对比其神经认知功能。4组受试者具体分组如下：1. CD4+ T细胞计数＞350 cells/mm³且HIV RNA≥1000 copies/ml，早期启动高效抗反转录病毒治疗（Highly Active Antiretroviral Therapy，HAART）的第1组；2. 与第1组CD4+ T细胞及HIV RNA水平一致，但未启动抗反转录病毒治疗的第2组；3. CD4+ T细胞计数＜350 cells/mm³，按照当时美国卫生与人类服务部（Department of Health and Human Services，DHHS）指南启动HAART的第3组；4. 与第3组CD4+ T细胞水平一致，但未启动抗反转录病毒治疗的第4组。其中第2组与第3组代表了彼时的临床标准治疗方案。本研究提供了初步数据，用于验证如下假说：相较于未接受治疗，或按照当时DHHS指南建议启动治疗的情况，提前启动HAART可获得更优的神经认知功能。