WHO NEUROPSYCHIATRIC AIDS STUDY, CROSS-SECTIONAL PHASE-II - NEUROPSYCHOLOGICAL AND NEUROLOGICAL FINDINGS

Background: The neuropsychological and neurological complications of H IV-1 infection and AIDS were explored within the cross-sectional phase of the WHO Neuropsychiatric AIDS Study. Special attention was devoted to the controversial issue of the prevalence and clinical significanc e of subtle cognitive deficits in asymptomatic seropositive subjects. Methods: A neuropsychological test battery validated for cross-cultura l use, a structured interview for the diagnosis of dementia, a rating scale of functioning in daily living activities, and a neurological mo dule were administered to representative samples of seropositive subje cts and to matched seronegative controls living in the five geographic areas predominantly affected by the HIV-I epidemic. Data are availabl e for five centers. Results: The prevalence of global neuropsychologic al impairment was significantly increased in asymptomatic seropositive subjects compared with controls in only two centers. A significant ef fect of education on neuropsychological performance was observed among asymptomatic serepositive individuals. In the two African centers, lo w-education, but not high-education, asymptomatic seropositive persons had an impaired performance. The frequency of impaired functioning in daily living activities and of neurologic abnormalities was higher in symptomatic, but not in asymptomatic, seropositive subjects compared with controls in all centers. Conclusions: These data suggest that the risk of subtle cognitive deficits may be increased in asymptomatic st ages of HIV-1 infection. However, these deficits are not associated wi th neurologic changes and do not seem to affect subjects' social funct ioning.