Decision Making Under Risk in Patients with HIV
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Abstract
Individuals with human immunodeficiency virus (HIV) develop neurocognitive impairments, more frequently as the systemic disease progresses to AIDS. Among HIV-infected persons receiving antiretroviral therapy, executive dysfunctions are very commonly impaired. The present study examined HIV-infected patients’ propensity for risky decision making using the Game of Dice Task (GDT), known to covary with executive dysfunctions. Although other tasks and types of decision making have been reported to be impaired in HIV patients, previous study cohorts were complicated by concurrent substance abuse and other comorbidities. Here we used a relatively comorbidity-free population. HIV-infected patients (N=20) were impaired in the GDT, compared to matched healthy controls (N=20). The HIV-infected group also showed an erratic decision strategy across the task. GDT performance was related to measures of executive functioning. Erratic GDT choices were related to current CD4+ T-cell levels. This study provides the first evidence for impaired risky decision making in an HIV-infected population.