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To determine whether neurological and neuropsychological abnormalities are associated with clinical manifestations of human immunodeficiency virus type 1(HIV-1)infection in men who do not have acquired immunodeficiency syndrome(AIDS),we performed a historical prospective and cross-sectional study.One hundred HIV-1 seropositive homosexual or bisexual men,of whom 26 had AIDS-related complex,31 had generalized lymphadenopathy,and 43 had no signs or symptoms of HIV-1 infection,and 157 HIV-1 seronegative men were enrolled from a cohort of 6,701 men who were originally recruited between 1978 and 1980 for studies of hepatitis B virus infection.Evaluation included medical history,physical examination,and neuropsychological tests.Of 26 HIV-1 seropositive subjects with AIDS-related complex,11(42%) reported neurological,cognitive,or affective symptoms compared with 30 (19%)of 157 HIV-1 seronegative subjects(relative risk=2.2,p=0.02).On neuropsychological testing,subjects with AIDS-related complex performed at a significantly lower level that the HIV-1 seronegative group(p=0.001).A significantly higher percentage of subjects with AIDS-related complex(8[ 31%]of 26)than HIV-1 seronegative subjects(19[12%]of 157)had abnormal results on two or more neuropsychological tests(rate ratio=2.5,p=0.03). Symptoms and impairment on neuropsychological tests were correlated only within the group who had AIDS-related complex.Subjects with generalized lymphadenopathy and subjects who had no signs or symptoms of HIV-1 infection were not different from HIV-1 seronegative subjects with respect to symptoms or performance on neuropsychological tests.Absolute T-helper lymphocyte count and estimated duration of HIV-1 infection were not associated with neuropsychological test results.These findings suggest that neurological and neuropsychological abnormalities are associated with AIDS-related complex but not with asymptomatic HIV-1 infection. |
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