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Gender and Neurological Functioning in HIV Infection K. ROBERTSON, B. VAUGHN, C. KAPOOR, W. ROBERTSON, J. KALKOWSKI, S. FISCUS, R. HELMS, and C. HALL*.
Univ. of North Carolina, Chapel Hill Objective: Despite increases in the number of HIV infected females over the last several years, little is known about HIV neurological disease in women. We are conducting a longitudinal study of gender differences in HIV related central and peripheral nervous system disease.
Methods: At baseline, thirty-four HIV+ females, forty-one HIV– females, and forty-nine HIV+ males were compared for age, education, absolute CD4 cell count, and plasma/CSF HIV RNA. Subjects were evaluated by neurological examination, clinical neurophysiological [visual (p100) and event related evoked potentials (P300)] every year.
Results: Both male and female HIV+ groups had poorer function on the neurologic examination and longer latencies on p300 evoked potentials than the HIV- group (p<.05). The p100 visual evoked potentials revealed longer latencies for HIV+ males compared to the HIV+ and HIV- females (p<.05). At entry, no gender differences were found in mean plasma (males 3.17 log cp/ml, females 3.06 log cp/ml) or CSF HIV RNA (males 1.52 log cp/ml, females 1.22 log cp/ml) viral load or neurological examination in infected subjects. However, after one year on study the HIV+ males demonstrated a decrease in plasma HIV RNA viral load (2.39 log cp/ml) compared to females (3.80 log cp/ml; p<.05), and an improvement in neurological examination (p< .01). This may be accounted for by increased antiretroviral use in the male (90%) but not the female (76%) group over time. No significant differences were found between HIV+ males and HIV+ females in CSF HIV RNA.
Conclusions: Although both male and female HIV+ groups had poorer functioning than HIV- female controls, these results show little difference in neurological functioning between HIV+ females and males at one year.
Key Words: gender, neurological disease
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