{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T06:50:46Z","timestamp":1784357446581,"version":"3.55.0"},"reference-count":36,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2007,9,25]],"date-time":"2007-09-25T00:00:00Z","timestamp":1190678400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Annals of Neurology"],"published-print":{"date-parts":[[2008,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Though effective anti\u2013human immunodeficiency virus (HIV) therapies are now available, they have variable penetration into the brain. We therefore aimed to assess changes over calendar time in the risk for HIV\u2010associated dementia (HIV\u2010D), and factors associated with HIV\u2010D risk.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Using Concerted Action on Seroconversion to AIDS and Death in Europe (CASCADE) data, we analyzed factors associated with time from HIV seroconversion to HIV\u2010D using Cox models with time\u2010updated covariates. The effect of duration of infection was explored using flexible parametric survival models.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>222 of 15,380 seroconverters developed HIV\u2010D. The incidence per 1,000 person\u2010years was 6.49 pre\u20101997 (before highly active antiretroviral therapy was available), declining to 0.66 by 2003 to 2006. Compared with most recent CD4 count \u2265 350 cells\/mm<jats:sup>3<\/jats:sup>, the adjusted relative risk (95% confidence interval) of HIV\u2010D was 3.47 (1.91\u20136.28), 10.19 (5.72\u201318.15), and 39.03 (22.96\u201366.36) at 200 to 349, 100 to 199, and 0 to 99 cells\/mm<jats:sup>3<\/jats:sup>, respectively. In 2003 to 2006, older age at seroconversion (relative risk = 3.24 per 10\u2010year increase [95% confidence interval, 2.00\u20135.24]) and previous acquired immune deficiency syndrome diagnosis (relative risk = 4.92 [95% confidence interval, 1.43\u201316.92]) were associated with HIV\u2010D risk, independently of current CD4 count. HIV\u2010D risk appeared to increase during chronic infection, by 48% at 10 years after seroconversion compared with the lowest risk at 1.8 years.<\/jats:p><\/jats:sec><jats:sec><jats:title>Interpretation<\/jats:title><jats:p>HIV\u2010D incidence has reduced markedly since 1997. However, patients with low (&lt;200 cells\/mm<jats:sup>3<\/jats:sup>) or even intermediate (200\u2013349 cells\/mm<jats:sup>3<\/jats:sup>) CD4 counts, previous acquired immune deficiency syndrome diagnosis, longer HIV infection duration, and older age at seroconversion are at increased risk and should be closely monitored for neurocognitive disorders. Ann Neurol 2007<\/jats:p><\/jats:sec>","DOI":"10.1002\/ana.21225","type":"journal-article","created":{"date-parts":[[2007,9,25]],"date-time":"2007-09-25T22:16:21Z","timestamp":1190758581000},"page":"213-221","source":"Crossref","is-referenced-by-count":151,"title":["Changes in the incidence and predictors of human immunodeficiency virus\u2013associated dementia in the era of highly active antiretroviral therapy"],"prefix":"10.1002","volume":"63","author":[{"given":"Krishnan","family":"Bhaskaran","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Mussini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Antinori","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ann Sarah","family":"Walker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Dorrucci","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline","family":"Sabin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Phillips","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kholoud","family":"Porter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"CASCADE Collaboration","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2008,2,27]]},"reference":[{"key":"e_1_2_7_2_2","doi-asserted-by":"publisher","DOI":"10.1002\/ana.410420504"},{"key":"e_1_2_7_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/00002030-200105040-00004"},{"key":"e_1_2_7_4_2","doi-asserted-by":"publisher","DOI":"10.1002\/ana.410190602"},{"key":"e_1_2_7_5_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.44.10.1892"},{"key":"e_1_2_7_6_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.282.23.2220"},{"key":"e_1_2_7_7_2","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/31.5.951"},{"key":"e_1_2_7_8_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.57.3.542"},{"key":"e_1_2_7_9_2","doi-asserted-by":"publisher","DOI":"10.1002\/ana.10827"},{"key":"e_1_2_7_10_2","doi-asserted-by":"publisher","DOI":"10.1212\/01.WNL.0000145763.68284.15"},{"key":"e_1_2_7_11_2","doi-asserted-by":"publisher","DOI":"10.1080\/13550280290049615"},{"key":"e_1_2_7_12_2","doi-asserted-by":"publisher","DOI":"10.1097\/00002030-200307040-00015"},{"key":"e_1_2_7_13_2","doi-asserted-by":"publisher","DOI":"10.1097\/00002030-200006160-00016"},{"key":"e_1_2_7_14_2","doi-asserted-by":"publisher","DOI":"10.1086\/498310"},{"key":"e_1_2_7_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(98)07333-4"},{"key":"e_1_2_7_16_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.aids.0000171409.38490.48"},{"key":"e_1_2_7_17_2","unstructured":"BestBM LetendreS PatelP et al.Low Atazanavir concentrations in cerebrospinal fluid. 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