ABSTRACT
This chapter has two major objectives:
To examine the prognostic influence of cognitive and psychosocial risk factors across the spectrum of HIV disease progression. To accomplish this we draw on a previous 13-year prospective study assessing the effect of general intellectual functioning, age, CD4, and emotional distress on HIV morbidity and mortality (Farinpour et al., 2003).
In order to further validate the findings and examine the degree to which brain reserve remains an influence for HIV disease progression, a replication study was conducted comprising a 5-year follow-up analysis utilizing the same study sample drawn from the Multicenter AIDS Cohort Study (MACS). The replication study was conducted specifically for the purposes of the present chapter and utilized the same baseline data points as the original study with a new observation period ending September 30, 2004.
Following study participants for an additional 5 years will allow an examination of the effects of highly active antiretroviral therapy (HAART) on HIV disease progression. Of the 13-year prospective study, it was only in the last 2 years from 1996 to 1998 that HAART was introduced. As it is widely known that HAART has had a profound effect on treatment of HIV/AIDS in general, it is also expected that the additional 5 years of data will show the effect of potent antiretroviral medication for the participants of the present study. It is of interest to ascertain whether brain reserve capacity remains a factor in predicting disease progression in the contemporary HAART era.