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Risk Factors of Marcotte et al for Early Neurocognitive Impairment in an HIV-Positive Patient

Description

Marcotte et al identified risk factors for early neurocognitive impairment in an HIV-positive patient. These can help identify a patient who may benefit from more aggressive management. The authors are from the San Diego HIV Neurobehavioral Research Center (HNRC) Group and University of California San Diego.


 

Patient selection: HIV seroconversion within the past 3 years. At presentation the patients were 3 months to 3 years from the time of seroconversion (median 1 year).

 

Parameters:

(1) CD4 cell count at baseline assessment

(2) plasma HIV RNA count at baseline assessment

 

Parameter

Finding

Points

CD4 count

>= 400 per µL

0

 

< 400 per µL

1

plasma HIV RNA

<= 4.5 LOG10 copies/mL

0

 

> 4.5 LOG10 copies/mL

1

 

where:

• LOG10 4.5 = 31,600

 

total score =

= SUM(points for both parameters)

 

Interpretation:

• minimum score: 0

• maximum score: 2

• A patient with a score of 2 is at significant risk for early neurocognitive impairment.

 

Number of Years from Baseline

Percent with Neurocognitive Impairment

2

12%

4

44%

6

62% (vs 15% for others)

 


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