Chapter 31 : Women and Neuro-AIDS Conditions in the Era of HAART

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Generally, HIV-1-positive women start highly active antiretroviral therapy (HAART) more rarely and later than men. HIV can affect the central and peripheral nervous system directly, provoking neurological signs and symptoms, and indirectly by causing immunodeficiency and thus susceptibility to infections with opportunistic infectious bodies. The incidence of HIV-1-associated dementia (HAD) has declined in the era of HAART, but in 2002, prevalence rates began to rise again due to the longer survival time of HIV-1-positive patients. On the whole, studies of neuro-AIDS conditions in women and how they possibly differ from men are scarce. There have been two studies analyzing the effect of HAART on neurocognitive performance in HIV-1-positive women. However, it is interesting that there are large cohort studies that analyze neurological disorders in homosexual and bisexual men, but even large studies like the Women's Interagency HIV Study do not automatically examine neuro-AIDS conditions but leave them to surprisingly small substudies. The HIV-1/AIDS-associated neurological manifestations increase with more intensive use of HAART and longer survival of affected people, including women. Thus, it is mandatory to gather more details on women developing neurological complications due to the virus itself or to HAART. The chapter talks about sex- and gender-specific data analysis in a German cohort of women living with HIV/AIDS.

Citation: Arendt G, Jaeger Y, Nolting T. 2009. Women and Neuro-AIDS Conditions in the Era of HAART, p 443-454. In Goodkin K, Shapshak P, Verma A (ed), The Spectrum of Neuro-AIDS Disorders. ASM Press, Washington, DC. doi: 10.1128/9781555815691.ch31
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Percentages of HIV-1-positive females (squares) and males (circles) with HAD 2 to 10 yrs after diagnosis of HIV-1 positivity.

Citation: Arendt G, Jaeger Y, Nolting T. 2009. Women and Neuro-AIDS Conditions in the Era of HAART, p 443-454. In Goodkin K, Shapshak P, Verma A (ed), The Spectrum of Neuro-AIDS Disorders. ASM Press, Washington, DC. doi: 10.1128/9781555815691.ch31
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Mean age of HIV-1-positive cohort at diagnosis

Citation: Arendt G, Jaeger Y, Nolting T. 2009. Women and Neuro-AIDS Conditions in the Era of HAART, p 443-454. In Goodkin K, Shapshak P, Verma A (ed), The Spectrum of Neuro-AIDS Disorders. ASM Press, Washington, DC. doi: 10.1128/9781555815691.ch31
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Mean duration of HIV-1 positivity with respect to risk groups

Citation: Arendt G, Jaeger Y, Nolting T. 2009. Women and Neuro-AIDS Conditions in the Era of HAART, p 443-454. In Goodkin K, Shapshak P, Verma A (ed), The Spectrum of Neuro-AIDS Disorders. ASM Press, Washington, DC. doi: 10.1128/9781555815691.ch31
Generic image for table

Death rate over 14 years

Citation: Arendt G, Jaeger Y, Nolting T. 2009. Women and Neuro-AIDS Conditions in the Era of HAART, p 443-454. In Goodkin K, Shapshak P, Verma A (ed), The Spectrum of Neuro-AIDS Disorders. ASM Press, Washington, DC. doi: 10.1128/9781555815691.ch31
Generic image for table

Age at death

Citation: Arendt G, Jaeger Y, Nolting T. 2009. Women and Neuro-AIDS Conditions in the Era of HAART, p 443-454. In Goodkin K, Shapshak P, Verma A (ed), The Spectrum of Neuro-AIDS Disorders. ASM Press, Washington, DC. doi: 10.1128/9781555815691.ch31
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Rates of AIDS and neuro-AIDS in HIV-1-positive cohort

Citation: Arendt G, Jaeger Y, Nolting T. 2009. Women and Neuro-AIDS Conditions in the Era of HAART, p 443-454. In Goodkin K, Shapshak P, Verma A (ed), The Spectrum of Neuro-AIDS Disorders. ASM Press, Washington, DC. doi: 10.1128/9781555815691.ch31
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CDC stages at first examination

Citation: Arendt G, Jaeger Y, Nolting T. 2009. Women and Neuro-AIDS Conditions in the Era of HAART, p 443-454. In Goodkin K, Shapshak P, Verma A (ed), The Spectrum of Neuro-AIDS Disorders. ASM Press, Washington, DC. doi: 10.1128/9781555815691.ch31
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Mean CD4 values of migrant and the control groups

Citation: Arendt G, Jaeger Y, Nolting T. 2009. Women and Neuro-AIDS Conditions in the Era of HAART, p 443-454. In Goodkin K, Shapshak P, Verma A (ed), The Spectrum of Neuro-AIDS Disorders. ASM Press, Washington, DC. doi: 10.1128/9781555815691.ch31
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Numbers of patients with opportunistic infections in the immigrant and control groups

Citation: Arendt G, Jaeger Y, Nolting T. 2009. Women and Neuro-AIDS Conditions in the Era of HAART, p 443-454. In Goodkin K, Shapshak P, Verma A (ed), The Spectrum of Neuro-AIDS Disorders. ASM Press, Washington, DC. doi: 10.1128/9781555815691.ch31

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