Cognitive function in asymptomatic HIV infection

Objective: To determine the nature and extent of cognitive deficits in early stage (asymptomatic) human immunodeficiency virus (HIV)-positive homosexual and bisexual men. Design: A cross-sectional design was used to compare 27 HIV-positive, asymptomatic (Centers for Disease Control and Prevention stages 2 and 3) homosexual and bisexual men, who were designated as the seropositive group, with 29 seronegative homosexual and bisexual men, who were designated as the control group. Methods: The participant groups were closely matched on a number of demographic and lifestyle variables. Participants were carefully and repeatedly screened for substance abuse, a history of psychiatric problems, use of psychoactive medications, and neurological problems. All participants completed an extensive neuropsychological battery and a computerized information processing battery to identify cognitive deficits. Results: No significant between-group differences were found on either the neuropsychological assessments or the information processing tests. Additionally, we found no evidence of a subgroup of seropositive, asymptomatic individuals with general cognitive slowing. Conclusions: Educated, HIV-positive asymptomatic individuals may show little difference in cognitive performance compared with a group of matched controls when the groups are carefully screened and matched. Additionally, computerized tests may be no more sensitive than neuropsychological tests to cognitive decrements for these types of participants.