This study estimated the frequency of nine primitive reflexes (PR) and assessed their possible clinical value in a group of patients with acquired immunodeficiency syndrome. We studied 78 patients with human inmunodeficiency type 1 (HIV-1) infection in WHO clinical stage 3 or 4 and 81 matched seronegative controls. All participants were examined using a standardized neurological examination and the Mini-Mental State Examination.
Cognitive impairment and PR was found in 36{f607f86846ba214ecc118a24d8f221d0f6091e2f284aa65c23a2cf36879dc8e8} of patients but in none of the controls (P<0.0001; logistic regression odds ratio: 14.7). Overall, PR were 2-36 times more frequent in patients with HIV-1 infection.
This association was stronger for the glabellar, snout, Rossolimo, and digital signs. At least two PR were observed in 92{f607f86846ba214ecc118a24d8f221d0f6091e2f284aa65c23a2cf36879dc8e8} of patients vs. 8{f607f86846ba214ecc118a24d8f221d0f6091e2f284aa65c23a2cf36879dc8e8} of controls (P<0.0001; 95{f607f86846ba214ecc118a24d8f221d0f6091e2f284aa65c23a2cf36879dc8e8} confidence interval: 68{f607f86846ba214ecc118a24d8f221d0f6091e2f284aa65c23a2cf36879dc8e8}-100{f607f86846ba214ecc118a24d8f221d0f6091e2f284aa65c23a2cf36879dc8e8}; logistic regression odds ratio: 10.8).
These data support the association of PR with cognitive decline in patients with advanced HIV-1 infection without overt neurological disease. Larger follow-up studies with multivariate techniques are needed to identify which PRs are useful as indicators of HIV-1-associated cognitive/motor complex and minor neurocognitive disorders.
