Primitive reflexes in a case-control study of patients with advanced humanimmunodeficiency virus type 1

This study estimated the frequency of nine primitive reflexes (PR) and asse ssed their possible clinical value in a group of patients with acquired imm unodeficiency syndrome. We studied 78 patients with human inmunodeficiency type 1 (HIV-1) infection in WHO clinical stage 3 or 4 and 81 matched serone gative controls. All participants were examined using a standardized neurol ogical examination and the Mini-Mental State Examination. Cognitive impairm ent and PR was found in 36% of patients but in none of the controls (P < 0. 0001; logistic regression odds ratio: 14.7). Overall, PR were 2-36 times mo re frequent in patients with HIV-1 infection. This association was stronger for the glabellar, snout, Rossolimo, and digital signs. At least two PR we re observed in 92% of patients vs. 8% of controls (P < 0.0001; 95% confiden ce interval: 68%-100%; logistic regression odds ratio: 10.8). These data su pport the association of PR with cognitive decline in patients with advance d HIV-1 infection without overt neurological disease. Larger follow-up stud ies with multivariate techniques are needed to identify which PRs are usefu l as indicators of HIV-1-associated cognitive/motor complex and minor neuro cognitive disorders.