Document 0003
 DOCN  M9580003
 TI    Neuropsychologic impairment in early HIV infection. A risk factor for
       work disability.
 DT    9506
 AU    Albert SM; Marder K; Dooneief G; Bell K; Sano M; Todak G; Stern Y;
       Gertrude H. Sergievsky Center, College of Physicians and; Surgeons,
       Columbia University, New York, USA.
 SO    Arch Neurol. 1995 May;52(5):525-30. Unique Identifier : AIDSLINE
       MED/95251575
 AB    OBJECTIVE: To explore the functional significance of incident
       neuropsychologic impairment among initially asymptomatic subjects
       infected with human immunodeficiency virus. DESIGN: Prospective,
       observational cohort study of homosexual and bisexual men to examine the
       incidence of work disability related to the onset of neuropsychologic
       impairment. SETTING: A university clinical and behavioral research site
       in New York City. PARTICIPANTS: Sample of 207 homosexual and bisexual
       men; 123 were seropositive and 84 were seronegative. PRINCIPAL OUTCOME
       MEASURES: Incident work disability in the course of 4.5 years of
       follow-up, with disability defined as a persistent (> or = 24 months)
       change in work hours (from 20 or more to less than 20 h/wk). RESULTS:
       Compared with seronegative control subjects (n = 72), the relative risk
       of work disability among initially asymptomatic seropositive men (n =
       44) was 2.76 (95% confidence interval, 1.2 to 6.5), nearly a threefold
       increase. Proportional hazards models show that this increased risk is
       attributable to the development of major neuropsychologic impairment in
       a subset (eight of 44) of the initially asymptomatic men, which is
       significantly associated with incident work disability (6/8 [75%]).
       Adjusting for symptom status and CD4+ cell count at the time of
       disability did not eliminate the increased risk associated with
       neuropsychologic impairment. CONCLUSIONS: In this cohort, the increased
       risk of work disability among initially asymptomatic human
       immunodeficiency virus-positive men was related to incident
       neuropsychologic impairment; such impairment predicted work disability
       independently of symptom status and CD4+ cell count over the follow-up
       period. Neuropsychologic impairment in the course of human
       immunodeficiency virus infection may indicate increased risk for poor
       outcomes over and above that associated with systemic disease.
 DE    Cohort Studies  Disability Evaluation  *Employment  Human  HIV
       Infections/PHYSIOPATHOLOGY/*PSYCHOLOGY  HIV Seronegativity  HIV
       Seropositivity  Male  Mental Disorders/*ETIOLOGY  Prospective Studies
       Risk Factors  Sex Behavior  Support, U.S. Gov't, P.H.S.  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).