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Nadir CD4 is a Predictor of HIV Neurocognitive Impairment (NCI) in the era of Combination Antiretroviral Therapy (CART): Results from the CHARTER Study
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Reported by Jules Levin
18th Intl AIDS Conference July 18-23 2010, Vienna Austria
Ronald Ellis, M.D., Ph.D.,1, Jayraan Badiee, M.P.H.1, Scott Letendre, M.D.1, Florin Vaida, Ph.D.1, Donald Franklin, B.S.1, Robert Heaton, Ph.D.1, David Clifford, M.D.2, Ann Collier, M.D.3, Christina Marra, M.D.3, Benjamin Gelman, M.D., Ph.D.4, Justin McArthur, M.B.B.S.5, Susan Morgello, M.D.6, David Simpson, M.D.6, J. Allen McCutchan, M.D.1, and Igor Grant, M.D.1, for the CHARTER Group
1University of California, San Diego, California; 2Washington University, St. Louis, Missouri; 3University of Washington, Seattle, Washington; 4University of Texas Medical Branch, Galveston, Texas; 5Johns Hopkins University, Baltimore, Maryland; 6Mt. Sinai School of Medicine, New York, New York
BACKGROUND
· Consensus clinical guidelines for when to initiate antiretroviral therapy have been recently revised to recommend earlier treatment than prior guidelines
· HIV-associated neurocognitive disorders (HAND) remain common despite combination ART and are associated with unemployment, disability, reduced ARV adherence and increased mortality after adjusting for other risks
· Neural injury acquired during advanced immunosuppression may be partially irreversible, contributing to HAND persistence
· Preventing advanced immunosuppression by initiating ART before it has occurred may reduce HAND risk
Table 1. Demographic and Clinical Characteristics of Study Population
1Mean (Standard Deviation); 2No. (%); 3Median (Inter-Quartile Range)
*p < 0.05; **p < 0.01; ***p < 0.0001
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