Robert K. Heaton Robert A. Velin J. Hampton Atkinson Steven J. Gulevich J. Allen McCutchan John R. Hesselink University of California School of Medicine
James L. Chandler Naval Hospital, San Diego
Igor Grant University of California School of Medicine
HNRC group University of California, San Diego and San Diego VA Medical Center
Since the early 1980s, we have been faced with a new and increasing source of neuropsychological morbidity as a result of infection with human immunodeficiency virus type-I (HIV-1). It is now generally accepted that neurocognitive impairment occurs in a significant number of individuals with acquired immune deficiency syndrome (AIDS) and AIDS related complex (ARC), and frank dementia is not uncommon in the late stages of infection. Current estimates suggest that up to one third of persons with advanced AIDS will become clinically demented at some stage of their illness, and up to another one third may manifest milder neuropsychological impairments not sufficiently severe to qualify for a diagnosis of dementia ( Grant & Heaton, 1990; Price & Brew, 1988).
In contrast to the general acceptance of neuropsychological dysfunction in AIDS and ARC, the prevalence of neuropsychological disturbances in HIV-1 infected individuals who do not yet show clear medical symptoms associated with significant immunosuppression (primarily Centers for Disease Control [CDC]