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Researchers have repeatedly demonstrated that HIV-associated neurocognitive impairment can arise or persist in patients who have achieved virologic suppression on antiretroviral therapy (JW AIDS Clin Care Mar 28 2011). What exactly is creating the risk in these patients, if it's not ongoing, uncontrolled systemic HIV replication? A new study points to the nadir CD4-cell count.
Among 1525 HIV-infected individuals participating in a multicenter observational study, 799 (52%) were found to have global neuropsychological impairment. Seventy-five percent of these individuals (39% of the total cohort) had no medical reason for this condition other than HIV infection. Patients with impairment were similar to those without impairment in terms of dem…