Document 0544
 DOCN  M9550544
 TI    Neurologic signs and symptoms in a cohort of homosexual men followed for
       4.5 years.
 DT    9505
 AU    Marder K; Liu X; Stern Y; Dooneief G; Bell K; Schofield P; Sacktor N;
       Todak G; Friedman R; Ehrhardt A; et al; Department of Neurology, College
       of Physicians and Surgeons,; Columbia University, New York, NY.
 SO    Neurology. 1995 Feb;45(2):261-7. Unique Identifier : AIDSLINE
       MED/95157743
 AB    We traced the development of neurologic impairment in 207 homosexual men
       (123 human immunodeficiency virus [HIV]-positive and 84 HIV-negative
       controls) over 4.5 years of follow-up. We applied generalized estimating
       equations to logistic regression analyses with repeated measures to
       examine the differences between HIV-positive and HIV-negative subjects
       with respect to the likelihood of developing six neurologic outcomes
       derived from a factor analysis, significant neurologic impairment
       (modified Kurtzke disability score of > or = 3), or significant
       neuropsychological impairment. We found that, over time, HIV-positive
       subjects were more likely to develop clinically significant
       extrapyramidal signs and frontal release signs than HIV-negative
       subjects. Controlling for age or education, as CD4 count declined, the
       odds of developing significant extrapyramidal signs, abnormalities in
       alternating movements, frontal release signs, and a Kurtzke score > or =
       3 increased. HIV-positive subjects were almost five times as likely
       (odds ratio [OR], 4.6; 95% CI, 1.6 to 13.4) as HIV-negative subjects to
       stay the same or worsen neurologically on the next visit, and those with
       CD4 < or = 200 were 4.8 times as likely (OR, 4.8; 95% CI, 2.2 to 10.7)
       to maintain or worsen neurologically relative to those with higher CD4
       counts. We conclude that neurologic impairment becomes increasingly
       apparent over time in HIV-infected men, especially in those with low CD4
       counts.
 DE    Adult  Cohort Studies  Comparative Study  *Homosexuality, Male  Human
       HIV Seronegativity/*PHYSIOLOGY  HIV
       Seropositivity/COMPLICATIONS/MORTALITY/*PHYSIOPATHOLOGY  Longitudinal
       Studies  Male  Nervous System Diseases/COMPLICATIONS/EPIDEMIOLOGY/
       *PHYSIOPATHOLOGY  *Neurologic Examination  Neuropsychological Tests
       Odds Ratio  Support, U.S. Gov't, P.H.S.  Time Factors  CLINICAL TRIAL
       CONTROLLED CLINICAL TRIAL  JOURNAL ARTICLE

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