Overall improvements in NC function were observed at week 24 and

Overall improvements in NC function were observed at week 24 and function continued to improve at week 48 (changes in z-score for overall cognitive global score of 0.16 and 0.18 at weeks 24 and 48, respectively). Within the NC speed domains, generally greater improvements were observed in arms 2 and 3, compared with arm 1 (changes in z-score for composite speed scores at weeks 24/48 of 0.16/0.16, –0.29/–0.24 and –0.15/–0.31 in arms 1, 2 and 3, respectively; P = 0.04 for

change at week 48 in arm 3 versus arm 1). Finally, improvements in executive function occurred later (only observed at week 48) and were driven by improvements in arm 3 (z-score changes of 0.23, 0.06 and –0.78 in arms 1, 2 and 3, respectively; P = 0.02 for change in arm 3 versus arm 1). Improvements HSP inhibition in NC function continue over the first year after initiating http://www.selleckchem.com/products/VX-765.html antiretroviral therapy in neuro-asymptomatic HIV-infected subjects. The beneficial effects of combination antiretroviral therapy (cART) on cerebral function in HIV-infected subjects have been well described and, on a population level, include a reduction in the incidence of severe HIV-related brain disease [1] and, on an individual level, improvements in cognitive function [2, 3] which

may have been impaired secondary to chronic HIV infection [4, 5]. Few studies have assessed the timing and dynamics of cognitive function improvement in HIV-infected subjects commencing effective cART for the first time. We recently described changes in cerebral function parameters in 30 HIV-infected subjects randomly allocated to commence three different antiretroviral regimens after 48 weeks of therapy [6]. The aim of this work was specifically to assess the dynamics of neurocognitive (NC) function changes over this 48-week period within a neurologically asymptomatic HIV-infected group initiating cART for the first time. Patients attending four sites (St Mary’s Hospital, London, UK; Queen Elizabeth Hospital, Kowloon, Hong Kong; HIV-NAT, Bangkok, Thailand; Southern Alberta HIV clinic, Calgary, Canada) and enrolled

in the ALTAIR study (a randomized, open-label, 96-week study comparing the safety and efficacy of three different combination antiretroviral regimens as initial therapy for HIV infection) Metalloexopeptidase [7] were eligible to enter this 48-week substudy. Study subjects were randomly allocated to commence cART comprising tenofovir/emtricitabine 300/200 mg once daily plus one of the following: efavirenz 600 mg once daily (arm 1), atazanavir/ritonavir 300/100 mg once daily (arm 2), or zidovudine/abacavir 250 or 300 mg twice daily/600 mg once daily (arm 3). Study entry criteria have previously been reported [6]. Of note, specific exclusion criteria included current or recent use of antidepressant or antipsychotic therapies, a current or recent history of alcohol or recreational drug dependence, established dementia and viral hepatitis C infection (hepatitis C virus antibody positive).

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