Estudo dos transtornos cognitivos decorrentes da infecção pelo HIV-1
Palabras clave:
Avaliação neuropsicológica, HIV, Transtornos cognitivosResumen
A infecção pelo vírus da imunodeficiência humana atinge o Sistema Nervoso Central nos estágios iniciais, causando manifestações neuropsicológicas. Com o objetivo de estudar o desempenho de indivíduos infectados por este vírus em relação às funções cognitivas, foram avaliados 20 pacientes com contagem de linfócitos CD4+ acima de 200 células/mm³, utilizando-se a Escala de Inteligência Wechsler para Adultos. Destes, cinco (25%) eram do sexo masculino e 15 (75%) do sexo feminino, com média de idade de 39,65 desvio-padrão de 10,15 anos. A contagem média de linfócitos CD4+ foi 467,20 desvio-padrão de 215,45 células/mm?. Dentre quatorze pacientes que fizeram uso de terapia antirretroviral de alta atividade foi observado um caso com desempenho das funções cognitivas atenção e aprendizagem muito abaixo da média; os demais (n=13) tiveram desempenho dentro da média. Por meio da Escala de Inteligência Wechsler para Adultos foi possível detectar desempenho abaixo do nível médio do funcionamento cognitivo em indivíduos com resultado positivo para vírus da imunodeficiência humana, mesmo em vigência de terapia antirretroviral de alta atividade.
Descargas
Citas
Ashford, J. W., Borson, S., O'Hara, R., Dash, P., Frank, L., Robert P., et al. (2007). Should older adults be screened for dementia? It is important to screen for evidence of dementia! The Journal of the Alzheimer's Association, 3 (2), 75-80.
Brasil. Ministério da Saúde. (2004). Critérios de definição de casos de AIDS em adultos e crianças. Série Manuais nº 60. Brasília: MS.
Brew, B. J. (2004). Evidence for a change in AIDS dementia complex in the era of highly active antiretroviral therapy and possibility of new a forms of AIDS dementia complex. AIDS, 18 (Suppl 1), S75-S70.
Brodt, H. R., Kamps, B. S., Gute P., Knupp, B., Staszewski, S., & Helm, E. B. (1997). Changing incidence of AIDS-defining illness in the era of antiretroviral combination therapy. AIDS, 11 (14), 1731-1739.
Chang, L., Ernest, T., Leonildo-Yee, M., Walot, I., & Singer, E. (1999). Cerebral metabolite abnormalities correlate with clinical severity of HIV-cognitive motor complex. Neurology, 52 (1), 100-108.
Clifford, D. B. (2002). AIDS dementia. The Medical Clinics of North America, 86 (3), 537-550.
Cohen, J. D., Perlstein, W. M., & Braver, T. S. (1997). Temporal dynamics of brain activation during a working memory task. Nature, 386 (6625), 604-608.
Cook, J., & Tyor, W. (2006). The patogenesis of HIV- associated dementia: recent advances using a SCID mouse model of dementia of HIV-encephalitis. The Einstein Journal of Biology and Medicine, 22 (1), 32-40.
Cysique, L.A., Maruff, P., & Brew, B.J. (2004). Prevalence and pattern of neuropsychological impairment in human immunodeficiency vírus-infected/acquired across pre and pos-highly active antiretroviral therapy eras: a combined study of two cohorts. Journal of Neurovirology, 10 (6), 350-357.
Grant, I., Atkinson, J. H., Hesselink, J. R., Kennedy, C. J., Richman, D. D., Spector, S. A., et al. (1987). Evidence for early central nervous system involvement in the acquired immunodeficiency syndrome (AIDS) and other HIV infection. Studies with neuropsychological testing and magnetic resonance imaging. Annals of Internal Medicine, 107 (6), 828-836.
Grassi, B., Graghebtini, G., Campana, A., Grassi, E., Bertelli, S., Cinque, P., et al. (1999). Spatial working memory in asymptomatic HIV-infected subjects. The Journal of Neuropsychiatry and Clinical Neurosciences, 11 (3), 387-391.
Griffin, D. E. (1997). Cytokines in the brain during viral infection: clues to HIV-associated dementia. The Journal of Clinical Investigation, 100 (12), 2948-2951.
Hinkin, C. H., Castellon, A. A., Durvasula, R. S., Hardy, D. J., Lam, M. N., Mason, K. I., et al. (2002). Medication adherence among HIV+ adults: effect of cognitive dysfunction and regimen complexity. Neurology, 59 (12), 1944-1950.
Kemppainen, J. K. (2004). Assessment of cognitive changes in HIV/AIDS. Neurology Today, 4 (11), 66-70.
Koralnik, I. J., Beaumanoir, A., Häusler, R., Kohler, A., Safran, A. B., Delacoux, R., et al. (1990). Controlled study of early neurological abnormalities in men with asymptomatic HIV infection. The New England Journal of Medicine, 323 (13), 864-870.
Law, W. A., Martin, A., Mapou, R. L., Roller, T. L., Salazar, A. M., Temoshok, L. R., et al. (1994). Working memory in individuals with HIV infection. Journal of Clinical and Experimental Neuropsychology, 16 (2), 173-182.
Lezak, M. D. (2004). Neuropsychological assessment. New York: Oxford University.
McArthur, J. C., Haughey, N., Gartner, S., Conant, K., Pardo, C., Nath, A., et al. (2003). Human immunodeficiency virus-associated dementia: an envolving disease. Journal of Neurovirology, 9 (2), 205-221.
Manji, H., & Miller, R. (2004). The neurology of HIV infection. Journal of Neurology, Neurosurgery, and Psychiatry, 5 (Suppl 1), i29-35.
Martin, E. M., Robertson, L. C., Edelstein, H. E., Jagust, W. J., Sorensen, D. J., San Giovanni, D., et al. (1992). Performance of patients with early HIV-1 infection on the stroop task. Journal of Clinical and Experimental Neuropsychology, 14 (5), 3311-3320.
Meehan, R. A., & Brush, J. A. (2001). An overview of AIDS dementia complex. American Journal of Alzheimer's Disease and other Dementias, 16 (4), 225-229.
Miller, E. N., Selnes, O. A., McArthur, J. C., Satz, P., Becker, J. T., Cohen, B. A., et al. (1990). Neuropsychological performance in HIV-1 infected homossexual men: the multicenter AIDS cohort study (MACS). Neurology, 40 (2), 197-203.
Newman, S. P, Lunn, S., & Harrison, M. J. C. (1995). Do asymptomatic HIV seropositive individuals show cognitive deficit? AIDS, 9 (11), 1211-1220.
Odiase, F. E., Ogurin, O. A., & Ogunniyi, A. A. (2007). Memory performance in HIV/AIDS- a prospective case control study. The Canadian Journal of Neurological Sciences, 34 (2), 154-159.
Paul, R. H., Cohen, R. A., & Stern, R. A. (2002). Neurocognitive manifestations of human immunodeficiencyvirus. CNS Spectrums, 7 (12), 860-866.
Sacktor, N., Lyles, R. H., Skolasky, R., Kleeberger, C., Selnes, O. A., Miller, E. N., et al. (2001). HIV-associated neurologic disease incidence changes. Multicenter AIDS cohort study, 1990-1998. Neurology, 56 (2), 257-260.
Seth, R., Granville-Grossman, K., Goldmeier, D., & Lynch, S. (1991). Psychiatric illnesses in patients whit HIV infection and AIDS referred to the liaison psychiatrist. The British Journal of Psychiatry, 159 (2), 347-350.
Simão, M. (2006). Apresentação. Boletim Epidemiológico-AIDS e DST, 3 (1) 3-6.
Suwanwelaa, N., Phanuphak, P., Phanthumchinda, K., Suwanwela, N. C., Tantivatana, J., Ruxrungtham, K., et al. (2000). Magnetic resonance spectroscopy of the brain in neurologically asymptomatic HIV-infected patients. Magnetic Resonance Imaging, 18 (7), 859-865.
Tozzi, V., Balestra, P., Galgani, S., Narciso, P., Sampaolesi, A., Antinori, A., et al. (2001). Changes in neurocognitive performance in cohort of patients treated with HAART for 3 years. Journal of Acquired Immune Deficiency Syndromes (1999), 28 (1), 19-27.
Vittiello, B., Goodkin, K., Ashtana, D., Shapshak, P., Atkindon, J..H., Helseltine. P..N., et al. (2007). HIV-1 RNA concentration and cognitive performance in a cohort of HIV-positive people. AIDS, 21 (11), 1415-1422.
Waldrop-Valverde, D., Ownby, R. L., Wilkie, F. L., Mack, A., Kumar, M., & Metsch L. Neurocognitive aspects of medication adherence in HIV-positive injecting drug users. AIDS and Behavior, 10 (3), 287-297.
Wechsler, D. (2004). Escala de inteligência para adultos: manual para administração e avaliação. São Paulo: Casa do Psicólogo.
Wilkie, F. L., Eisdorfer, C., Morgan, R., Loewenstein, D. A., & Szapocznik, J. (1990). Cognition in early human immunodeficiency virus infection. Archives of Neurology, 47 (4), 433-440.
World Health Organization. (2006). Global estimates for adults and children. Geneva: WHO.
Descargas
Publicado
Cómo citar
Número
Sección
Licencia
Derechos de autor 2022 Rosângela Souza KALIL, Regina Maria Papais ALVARENGA, Adilson José de ALMEIDA, Carlos Alberto MORAIS-DE-SÁ
Esta obra está bajo una licencia internacional Creative Commons Atribución 4.0.