{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T15:43:13Z","timestamp":1792424593564,"version":"4.5.0"},"reference-count":42,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2020,11,12]],"date-time":"2020-11-12T00:00:00Z","timestamp":1605139200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/100006483","name":"AbbVie","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006483","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Oeuvre du Perp\u00e9tuel Secours association"},{"name":"French-British Hospital"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,2,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Despite the effectiveness of antiretroviral (ARV) therapy to control HIV infection, HIV-associated neurocognitive disorders (HAND) remain frequent. The Neuro+3 study assessed the cognitive improvement associated with ARV intensification based on increased CNS penetration effectiveness (CPE) scoring \u2265+3 and total CPE score \u22659.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Thirty-one patients, aged 18\u201365\u2009years, with confirmed diagnosis of HAND and effective ARV therapy were included. The cognitive improvement was measured using Frascati three-stage classification and global deficit score (GDS) after 48 and 96\u2009weeks of ARV intensification. Ultrasensitive HIV-RNA, neopterin, soluble CD14, CCL2, CXCL10, IL6, IL8 and NF-L were measured in plasma and cerebrospinal fluid at Day 0 (baseline), Week 48 (W48) and W96.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The intensified ARV was associated with a median (IQR) CPE score increase from 6 (4\u20137) at baseline to 10 (9\u201311). From baseline to W96, the median (IQR) GDS decreased from 1.4 (0.8\u20132.2) to 1.0 (0.6\u20132.0) (P\u200a=\u200a0.009); HAND classification improved from 2 to 1 HIV-associated dementia, 22 to 8 mild neurocognitive disorders, 7 to 17 asymptomatic neurocognitive impairment and 0 to 5 patients without any neurocognitive alterations (P\u200a=\u200a0.001). In multivariable linear regression analysis, GDS improvement at W96 was significantly associated with CPE score \u22659 after intensification (P\u200a=\u200a0.014), CD4 lymphocyte increase at W48 (P\u200a&amp;lt;\u200a0.001) and plasma CXCL10 decrease at W96 (P\u200a=\u200a0.001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In patients with HAND, a significant cognitive improvement was observed after the ARV intensification strategy, with a higher CPE score. Cognitive improvement was more often observed in the case of a switch of two drug classes, arguing for better control of CNS HIV immune activation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jac\/dkaa473","type":"journal-article","created":{"date-parts":[[2020,10,28]],"date-time":"2020-10-28T08:11:23Z","timestamp":1603872683000},"page":"743-752","source":"Crossref","is-referenced-by-count":18,"title":["Improvement of HIV-associated neurocognitive disorders after antiretroviral therapy intensification: the Neuro+3 study"],"prefix":"10.1093","volume":"76","author":[{"given":"Gilles","family":"Force","sequence":"first","affiliation":[{"name":"French-British Hospital Institute, Levallois-Perret, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Idir","family":"Ghout","sequence":"additional","affiliation":[{"name":"APHP Hospital Ambroise Par\u00e9, Versailles Saint Quentin en Yvelines University, Boulogne, 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