HIV-INFECTION AND DRUG-USE - INFLUENCE ON COGNITIVE FUNCTION

Objective: To examine the involvement of cognitive function in HIV-ser opositive drug users (DU) in a pre-AIDS state. Design: Fifty-six HIV-p ositive DU were prospectively evaluated. They belonged to groups II, I II and IV (subgroups A, C2 and E) of the 1987 Centers for Disease Cont rol and Prevention classification, with anamnesis negative for neurolo gical pathology. HIV-negative DU (n = 19) and non-DU (n = 27) were use d as controls. Infection with HIV and use of toxic drugs were consider ed variables of influence on cognitive function. Method: Subjects unde rwent neuropsychological evaluation by tests designed to explore corti cal and subcortical function. Results: HIV-positive DU showed worse pe rformance scores at the psychometric tests than HIV-negative non-DU, b ut there was no difference when compared with HIV-negative DU. Ex-DU s howed better performance than active DU. No difference with regard to degree of disease evolution was observed among HIV-positive individual s (i.e., groups II and III versus group IV). Conclusions: There was no evidence of cognitive deficits in HIV-positive individuals in non-AID S phases to indicate early involvement by HIV at the cerebral level. P rogression of the disease, prior to the AIDS phase, did not determine a worsening of intellectual performance. Instead, cognitive function w as affected by the chronic and current use of toxic substances. In HIV -positive DU, a decline in cognitive function was found to be attribut able to the chronic use of toxic substances rather than HIV infection.