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dc.contributor.authorPérez-Valero, Ignacio
dc.contributor.authorGonzález-Baeza, Alicia
dc.contributor.authorEstébanez, Miriam
dc.contributor.authorMontes-Ramírez, María Luisa
dc.contributor.authorBayón Pérez, Carmen 
dc.contributor.authorPulido, Federico
dc.contributor.authorBernardino, José Ignacio
dc.contributor.authorZamora, Francisco Xavier
dc.contributor.authorMonge, Susana
dc.contributor.authorGayá, Francisco
dc.contributor.authorLagarde, María
dc.contributor.authorRubio, Rafaël
dc.contributor.authorHernando, Asunción
dc.contributor.authorArnalich Fernández, Francisco 
dc.contributor.authorArribas, José Ramón
dc.contributor.otherUAM. Departamento de Medicinaes_ES
dc.date.accessioned2015-06-18T12:42:18Z
dc.date.available2015-06-18T12:42:18Z
dc.date.issued2013-07-25
dc.identifier.citationPlos One 8.7 (2013): e69493en_US
dc.identifier.issn1932-6203 (online)en_US
dc.identifier.urihttp://hdl.handle.net/10486/666908
dc.description.abstractBackground:In patients who remain virologically suppressed in plasma with triple-drug ART a switch to protease inhibitor monotherapy maintains high rates of suppression; however it is unknown if protease inhibitor monotherapy is associated to a higher rate of neurocognitive impairment.Methods:In this observational, cross-sectional study we included patients with plasma virological suppression (≥1 year) without concomitant major neurocognitive confounders, currently receiving for ≥1 year boosted lopinavir or darunavir as monotherapy or as triple ART. Neurocognitive impairment was defined as per the 2007 consensus of the American Association of Neurology. The association between neurocognitive impairment and protease inhibitor monotherapy, adjusted by significant confounders, was analysed.Results:Of the 191 included patients - triple therapy: 96, 1-2 years of monotherapy: 40 and >2 years of monotherapy: 55 - proportions (95% CI) with neurocognitive impairment were: overall, 27.2% (20.9-33.6); triple therapy, 31.6% (22.1-41.0); short-term monotherapy, 25.0% (11.3-38.7); long-term monotherapy: 21.4% (10.5-32.3); p = 0.38. In all groups, neurocognitive impairment was mildly symptomatic or asymptomatic by self-report. There were not significant differences in Global Deficit Score by group. In the regression model confounding variables for neurocognitive impairment were years on ART, ethnicity, years of education, transmission category and the HOMA index. Adjusted by these variables the Odds Ratio (95% CI) for neurocognitive impairment of patients receiving short-term monotherapy was 0.85 (0.29-2.50) and for long-term monotherapy 0.40 (0.14-1.15).Conclusions:Compared to triple drug antiretroviral therapy, monotherapy with lopinavir/ritonavir or darunavir/ritonavir in patients with adequate plasma suppression was not associated with a higher rate of asymptomatic neurocognitive impairment than triple drug ARTen_US
dc.description.sponsorshipThis work was supported by grant PI10/00483, Fondo de Investigaciones Sanitarias, Insituto de Salud Carlos III. Dr I. Pérez-Valero, Dr. M. Estébanez, Dr. F.X. Zamora and S. Monge are supported by Río Hortega fellowships financed by Fondo de Investigaciones Sanitarias. Dr. M. Lagarde is supported by a fellowship financed by Instituto de Investigación Hospital 12 de Octubre (i+12). Dr. J.R. Arribas is an investigator from the Programa de Intensificación de la Actividad Investigadora en el SNS (I3SNS). IdiPAZ AIDS and infectious diseases investigator group is partially supported by ‘‘Red de Investigación en SIDA’’ (AIDS Research Network) (RIS) RD07/0006/2007en_US
dc.format.extent7 pag.es_ES
dc.format.mimetypeapplication/pdfen
dc.language.isoengen
dc.publisherPublic Library of Scienceen_US
dc.relation.ispartofPlos Oneen_US
dc.rights© 2013 Pérez-Valero et al.es_ES
dc.subject.otherAntiretroviral Therapyen_US
dc.subject.otherCross-Sectional Studiesen_US
dc.subject.otherNeuropsychological Testsen_US
dc.subject.otherSulfonamidesen_US
dc.subject.otherDrug Administration Scheduleen_US
dc.titleNeurocognitive impairment in patients treated with protease inhibitor monotherapy or triple Drug Antiretroviral Therapyen_US
dc.typearticleen
dc.subject.ecienciaMedicinaes_ES
dc.identifier.doi10.1371/journal.pone.0069493es_ES
dc.identifier.publicationfirstpagee69493es_ES
dc.identifier.publicationissue7es_ES
dc.identifier.publicationlastpagee69493es_ES
dc.identifier.publicationvolume8es_ES
dc.type.versioninfo:eu-repo/semantics/publishedVersionen
dc.rights.ccReconocimientoes_ES
dc.rights.accessRightsopenAccessen
dc.authorUAMBayon Pérez, Carmen (261797)
dc.facultadUAMFacultad de Medicina
dc.institutoUAMInstituto de Investigación Sanitaria Hospital Universitario de La Paz (IdiPAZ)


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