Cognitive change over one year among older adults with HIV and a low nadir CD4 cell count
Bibliographic record
Abstract
Abstract Background Evidence regarding the risk of cognitive decline conferred by a low nadir CD4 cell count and increasing age in people living with HIV is mixed. The objective of this study was to assess the change in cognition over one year among older adults with well-controlled HIV infection and a history of low nadir CD4 cell count compared with the change in a matched non-HIV sample. Methods We recruited 50 HIV+ aviremic individuals 40 years or older, on stable antiretroviral treatment and with a nadir CD4 < 200 cells/μL, and seventeen matched HIV-negative individuals. Neuropsychological testing was performed twice, one year apart; an NPZ was computed by averaging all z-scores and five existing algorithms for a diagnosis of HAND were applied. Change was defined as making a reliable change on the NPZ or a change in HAND category (impaired vs not). Results Change in NPZ over one year was more often in the direction of an improvement, and not different between HIV+ and HIV-individuals. Among the HIV+, the proportion meeting criteria for HAND at baseline ranged from 34-80% depending on the classification algorithm. A reliable change in NPZ was demonstrated in a single HIV+ participant. In contrast, a transition between HAND category at one year was common. Conclusion Among aviremic HIV+ older adults with a history of low nadir CD4 cell count, change in NPZ over 1 year was comparable to that seen among demographically matched HIV-individuals and did not represent a reliable change while transition across HAND category was common. Rates of HAND were very dependent on the classification algorithm applied. These findings provide some explanation for the inconsistent findings from existing studies and highlight the importance of exercising caution when pooling results in the field of neuroHIV.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".