Neurocognitive Function After Interruption of Antiretroviral Therapy

HIV can cause neurocognitive dysfunction, ranging from minor impairment to profound dementia. Although severe cognitive impairment is more common in patients with low CD4-cell counts, HIV is found in the central nervous system from the first days of infection. Because neurocognitive function improves with antiretroviral therapy (ART), investigators predicted that it would worsen with ART discontinuation, even in patients who initiated therapy at high CD4-cell counts.

In a single-arm study, 167 asymptomatic HIV-infected patients underwent serial neurocognitive testing after stopping ART. (The trial was initiated before other studies proved that treatment interruption had deleterious clinical consequences [JW Infect Dis Nov 29 2006].) Enrollee…