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).