TY - JOUR
T1 - Neurologic signs and symptoms in a cohort of homosexual men followed for 4.5 years
AU - Marder, K.
AU - Liu, X.
AU - Stern, Y.
AU - Dooneief, G.
AU - Bell, K.
AU - Schofield, P.
AU - Sacktor, N.
AU - Todak, G.
AU - Friedman, R.
AU - Ehrhardt, A.
AU - Stein, Z.
AU - Gorman, J.
AU - Mayeux, R.
PY - 1995/2
Y1 - 1995/2
N2 - We traced the development of neurologic impairment in 207 homosexual men (123 human immunodeficiency virus [HIV]-positive and 84 HIV-negative controls) over 4.5 years of follow-up. We applied generalized estimating equations to logistic regression analyses with repeated measures to examine the differences between HlV-posi- tive and HIV-negative subjects with respect to the likelihood of developing six neurologic outcomes derived from a factor analysis, significant neurologic impairment (modified Kurtzke disability score of >3), or significant neuropsychological impairment. We found that, over time, HIV-positive subjects were more likely to develop clinically significant extrapyramidal signs and frontal release signs than HIV-negative subjects. Controlling for age or education, as CD4 count declined, the odds of developing significant extrapyramidal signs, abnormalities in alternating movements, frontal release signs, and a Kurtzke score >3 increased. HIV-positive subjects were almost five times as likely (odds ratio [OR], 4.6; 95% Cl, 1.6 to 13.4) as HIV-negative subjects to stay the same or worsen neurologically on the next visit, and those with CD4 <200 were 4.8 times as likely (OR, 4.8; 95% Cl, 2.2 to 10.7) to maintain or worsen neurologically relative to those with higher CD4 counts. We conclude that neurologic impairment becomes increasingly apparent over time in HIV-infected men, especially in those with low CD4 counts.
AB - We traced the development of neurologic impairment in 207 homosexual men (123 human immunodeficiency virus [HIV]-positive and 84 HIV-negative controls) over 4.5 years of follow-up. We applied generalized estimating equations to logistic regression analyses with repeated measures to examine the differences between HlV-posi- tive and HIV-negative subjects with respect to the likelihood of developing six neurologic outcomes derived from a factor analysis, significant neurologic impairment (modified Kurtzke disability score of >3), or significant neuropsychological impairment. We found that, over time, HIV-positive subjects were more likely to develop clinically significant extrapyramidal signs and frontal release signs than HIV-negative subjects. Controlling for age or education, as CD4 count declined, the odds of developing significant extrapyramidal signs, abnormalities in alternating movements, frontal release signs, and a Kurtzke score >3 increased. HIV-positive subjects were almost five times as likely (odds ratio [OR], 4.6; 95% Cl, 1.6 to 13.4) as HIV-negative subjects to stay the same or worsen neurologically on the next visit, and those with CD4 <200 were 4.8 times as likely (OR, 4.8; 95% Cl, 2.2 to 10.7) to maintain or worsen neurologically relative to those with higher CD4 counts. We conclude that neurologic impairment becomes increasingly apparent over time in HIV-infected men, especially in those with low CD4 counts.
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U2 - 10.1212/WNL.45.2.261
DO - 10.1212/WNL.45.2.261
M3 - Article
C2 - 7854523
AN - SCOPUS:0028796379
SN - 0028-3878
VL - 45
SP - 261
EP - 267
JO - Neurology
JF - Neurology
IS - 2
ER -