A controlled two year follow up of neuropsychological status in HIV seropositive and HIV seronegative adolescent haemophiliacs

Research published in the late 1980s from various centres indicated that there could be subtle neuropsychological dysfunctions in asymptomatic HIV Seropositive individuals. It was considered possible that such subtle dysfunctions were an early indicator for the later development of AIDS related dementia. The early research indicated that AIDS related dementia had a characteristic frontal and sub-cortical pattern of damage, with consequences for functioning in specific executive skills. This study was designed to test the hypothesis that young HIV Seropositive Haemophiliacs would produce increasingly poor performance over two years, compared to two control groups in terms of cognitive and psychiatric functioning. 28 male HIV Seropositive Haemophiliacs, infected between the ages 5 to 18 years and aged under 25 years at first assessment for this study, were recruited from three UK Regional Haemophilia Centres. The HIV Positives were compared against two control groups: HIV Seronegative Haemophiliacs [n = 25] and age matched HIV Seronegative Non-Haemophiliacs [n = 12]. All participants were assessed on an extensive neuropsychological test battery and a psychiatric interview. The study design was mixed, having both longitudinal (repeated) measurement and three different groups. Reported here are the comparisons from the three annual assessments for the three groups of participants. The first annual (1A) assessment, reported in Thompson et al (1996), indicated that the HIV Positives were performing overall at least as well as the control groups in all areas, which was contrary to expectations for a group 4-9 years post-HIV-infection. The follow-up allowed cross-sectional analyses at the second (2A) and third (3A) annual assessments and the longitudinal analysis of the results. This indicated that there was very little psychiatric morbidity, which is consistent with the view (Thompson et aI, 1996) that the high levels of psychological support provided by the Haemophilia Centres can alleviate the effects of the illness on emotions and behaviour. The cross-sectional analyses and the longitudinal analysis of the key variables from each test in the neuropsychological battery indicated that the HIV Positive group were performing at least as well as the control groups throughout this study. Conclusion: the HIV Positives were performing at least as well as the HIV Negative Haemophiliacs and the Non-haemophiliac Control group in all areas over the two years of the study. Therefore the concern about young Haemophiliac males developing subtle cognitive dysfunction or psychiatric symptoms related to their HIV Seropositivity was found not to be justified for this sample.