Pharmacy News Article

Scientists discuss in 'Aging exacerbates extrapyramidal motor signs in the era of highly active antiretroviral therapy' new findings in HIV/AIDS co-infection. "The phenotype of human immunodeficiency virus (HIV)-associated neurocognitive disorders (HAND) in the developed world has changed with the broad institution of highly active antiretroviral therapy (HAART) and with aging of the HIV+ population. Extrapyramidal motor signs were a prominent feature of HAND as defined in the early stages of the epidemic but has not been reevaluated in the era of HAART," scientists writing in the Journal of Neurovirology report (see also HIV/AIDS Co-Infection Therapy).

"Moreover, the contribution of aging to extrapyramidal motor signs in the context of HIV remains undefined. We examined these questions among the 229 HIV+ participants in the Hawaii Aging with HIV Cohort compared to age-, gender-, and ethnicity-matched HIV-negative controls. Extrapyramidal motor signs were quantified using the motor exam of the Unified Parkinson's Disease Rating Scale (UPDRSmotor) and compared to concurrent neuropsychological and clinical cognitive diagnostic categorization. The mean UPDRSmotor score increased with older age (1.68 versus 3.35; p<.001) and with HIV status (1.18 versus 3.56; p<.001). Age group (p=.024), HIV status (p <.001), and the interaction between age and HIV (p=.026) were significantly associated with UPDRSmotor score. Among HIV+ patients, the mean UPDRSmotor score increased with worsening cognitive diagnostic category (p <.001) where it was 2.06 (2.31) in normal cognition (n=110), 3.21 (3.48) in minor cognitive motor disorder (MCMD) (n=84), and 5.72 (5.01) in HIV-associated dementia (HAD) (n=37). We conclude that extrapyramidal motor signs are increased in HIV in the era of HAART and that the impact of HIV on extrapyramidal motor signs is exacerbated by aging," wrote V. Valcour and colleagues, University of Hawaii.

The researchers concluded: "These results highlight the importance of a careful neurological examination in the evaluation of HIV patients."

Valcour and colleagues published their study in the Journal of Neurovirology (Aging exacerbates extrapyramidal motor signs in the era of highly active antiretroviral therapy. Journal of Neurovirology, 2008;14(5):362-7).

Additional information can be obtained by contacting V. Valcour, University of Hawaii, Hawaii AIDS Clinical Research Program, John A Burns School of Medicine, Honolulu, Hawaii USA..

The publisher of the Journal of Neurovirology can be contacted at: Taylor & Francis Group Ltd, 2 Park Square, Milton Park, Abingdon, Oxford OX14 4RN United Kingdom.