HIV‐associated neurocognitive impairment in stable people living with HIV on ART in rural Tanzania

HIV Medicine ◽  
2020 ◽  
Author(s):  
M Sanmartí ◽  
AC Meyer ◽  
A Jaen ◽  
K Robertson ◽  
N Tan ◽  
...  
Keyword(s):  
Neurocognitive Impairment ◽  
People Living With Hiv ◽  
Rural Tanzania ◽  
Living With Hiv

scholarly journals Psycho-behavioral factors associated with neurocognitive performance among people living with HIV on antiretroviral therapy in Accra, Ghana

2020 ◽  
Vol 20 (2) ◽  
pp. 587-596
Author(s):  
Nana Asiedu ◽  
Irene Kretchy ◽  
Emmanuel Asampong
Keyword(s):  
Operating Characteristic ◽  
Neurocognitive Impairment ◽  
People Living With Hiv ◽  
Neurocognitive Performance ◽  
Factors Associated ◽  
Non Invasive ◽  
Hiv Management ◽  
Behavioural Factors ◽  
Living With Hiv ◽  
Selection Of

Background: It is estimated that almost half of all people living with HIV have some form of neurocognitive impairment, but few studies have looked at the risk of neurocognitive impairment and its associated factors in Ghana, due in part to limited resources for such testing. Objective: To examine neurocognitive performance in a group of Ghanaians living with HIV and possible factors that contribute to their performance. Methods: One hundred and four patients were assessed using a selection of brief non-invasive neuropsychological assess- ments as well as the International HIV Dementia Scale. Psycho-behavioural factors (alcohol use, depression, and medication adherence) as well as demographic characteristics and functional daily activities were assessed to determine their association with neurocognitive performance, using linear regression and receiver operating characteristic analyses. Results: About 48% of the participants met the criteria for risk of neurocognitive impairment. Age, education, and symp- toms of depression were found to be significantly associated with the risk of impairment. Conclusion: Some people living with HIV showed risk of neurocognitive impairment, which was significantly associated with education, age and depressive symptoms. It is therefore important to consider routine neurocognitive screening in HIV management to recognize any risks for early interventions. Keywords: ART adherence; depression; neurologic disease.

scholarly journals Antiretroviral therapy improves neurocognitive impairment in people living with HIV? A meta-analysis

2020 ◽  
Vol 7 (2) ◽  
pp. 238-247 ◽  
Author(s):  
Chang Gao ◽  
Jingjing Meng ◽  
Xueling Xiao ◽  
Min Wang ◽  
Ann Barterley Williams ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Meta Analysis ◽  
Neurocognitive Impairment ◽  
People Living With Hiv ◽  
Living With Hiv

scholarly journals Metabolic Risk Factors as Differential Predictors of Profiles of Neurocognitive Impairment Among Older HIV+ and HIV− Adults: An Observational Study

2019 ◽  
Author(s):  
Elizabeth C Pasipanodya ◽  
Jessica L Montoya ◽  
Laura M Campbell ◽  
Mariam A Hussain ◽  
Rowan Saloner ◽  
...  
Keyword(s):  
Risk Factors ◽  
High Probability ◽  
Latent Class ◽  
Neurocognitive Impairment ◽  
Metabolic Risk Factors ◽  
People Living With Hiv ◽  
Significant Heterogeneity ◽  
Metabolic Risk ◽  
Multinomial Regression ◽  
Living With Hiv

Abstract Objective Neurocognitive performance among older persons, including those living with HIV (people living with HIV [PLWH]), exhibits significant heterogeneity, suggesting subpopulations with differing profiles of neurocognitive impairment (NCI). Metabolic factors are associated with NCI, but their relationships to cluster-derived NCI profiles are unknown. Method Participants (144 PLWH and 102 HIV uninfected) aged 50+ years completed a neuropsychological battery assessing seven cognitive domains. Latent class analysis (LCA) identified NCI profiles separately by HIV serostatus and in a combined sample. Obtained classes were examined against the Montreal Cognitive Assessment (MoCA) and diagnoses of HIV-associated neurocognitive disorders (HAND). Multinomial regression identified metabolic predictors of classification. Results LCA identified three latent classes in each participant sample: Class1Multidomain NCI (high probability of impairment across multiple domains), Class 2Learning & Recall NCI (high probability of impairment in learning and recall), and Class 3NC Unimpaired (low probability of NCI across all domains). Severity of NCI implied by classes corresponded with MoCA scores and HAND diagnoses. In analyses on the combined sample, compared to HIV-uninfected individuals, PLWH were more likely to be in Class1Multidomain NCI. Among PLWH, those with dyslipidemia and hypertension had greater odds of classification in Class 1Multidomain NCI while those with central obesity had higher odds of classification in Class 2Learning & Recall NCI; metabolic syndrome approached significance as a differential predictor. Regardless of HIV status, individuals with diabetes were more likely to be in Class 1Multidomain NCI. Conclusions Metabolic risk factors confer heightened risk of NCI in HIV infection. Interventions to reduce metabolic risk may improve neurocognitive outcomes among PLWH.

scholarly journals Benzodiazepine Use Is Associated With an Increased Risk of Neurocognitive Impairment in People Living With HIV

2019 ◽  
Vol 82 (5) ◽  
pp. 475-482 ◽  
Author(s):  
Rowan Saloner ◽  
David J. Grelotti ◽  
Griffin Tyree ◽  
Erin E. Sundermann ◽  
Qing Ma ◽  
...  
Keyword(s):  
Neurocognitive Impairment ◽  
People Living With Hiv ◽  
Increased Risk ◽  
Benzodiazepine Use ◽  
Living With Hiv

scholarly journals The Role of Mental Health Conditions in the Diagnosis of Neurocognitive Impairment in People Living with HIV

Diagnostics ◽  
2020 ◽  
Vol 10 (8) ◽  
pp. 543
Author(s):  
Irene Portilla-Tamarit ◽  
Nicolás Ruiz-Robledillo ◽  
Marcos Díez-Martínez ◽  
Rosario Ferrer-Cascales ◽  
Cristian Alcocer-Bruno ◽  
...  
Keyword(s):  
Mental Health ◽  
Antiretroviral Treatment ◽  
Neurocognitive Impairment ◽  
Health Condition ◽  
Health Conditions ◽  
People Living With Hiv ◽  
Mental Health Condition ◽  
Hiv Viral Load ◽  
Mental Health Conditions ◽  
Living With Hiv

The aims of the present study were to evaluate the prevalence of undiagnosed mental health conditions (UMHC) in people living with HIV (PLWHIV) on antiretroviral treatment and with long-term suppressed HIV viremia, and its association with neurocognitive impairment (NCI). A cross-sectional observational study on HIV subjects, ≥18 years old, on stable antiretroviral treatment and with HIV viral load <50 copies/mL was carried out. Patients with known comorbidities, substances abuse, anxiety or depression were excluded. UMHC were evaluated by the Millon Clinical Multiaxial Inventory-III and NCI by Frascati criteria. The association between NCI and sociodemographic, clinical HIV variables and mental health conditions was analyzed. Further, the relationship between mental health conditions scores and NCI diagnosis was evaluated. Eighty patients were included, 37.5% had at least one undiagnosed mental health condition, and 26.3% had NCI. The most frequent mental health conditions were: anxiety (21.3%); bipolar disorder (11.3%); and substance dependence (8.8%). Only longer time since HIV diagnosis (p = 0.030) and at least one mental health condition diagnosis (p = 0.002) showed an association with NCI. Participants with NCI presented higher scores in anxiety, alcohol dependence and post-traumatic stress. Undiagnosed mental health conditions are frequent in PLWHIV. These disorders cannot be identified by HIV clinicians or basic screening questionnaires, and they are not usually self-reported by patients. UMHC could act as confounders in the evaluation of NCI.

scholarly journals Age-related comorbidities and mortality in people living with HIV in rural Tanzania

AIDS ◽  
2019 ◽  
Vol 33 (6) ◽  
pp. 1031-1041 ◽  
Author(s):  
Sascha Albrecht ◽  
Fabian C. Franzeck ◽  
Herry Mapesi ◽  
Christoph Hatz ◽  
Aneth Vedastus Kalinjuma ◽  
...  
Keyword(s):  
People Living With Hiv ◽  
Rural Tanzania ◽  
Age Related ◽  
Living With Hiv

scholarly journals Cannabis Exposure is Associated With a Lower Likelihood of Neurocognitive Impairment in People Living With HIV

2020 ◽  
Vol 83 (1) ◽  
pp. 56-64 ◽  
Author(s):  
Caitlin Wei-Ming Watson ◽  
Emily W. Paolillo ◽  
Erin E. Morgan ◽  
Anya Umlauf ◽  
Erin E. Sundermann ◽  
...  
Keyword(s):  
Neurocognitive Impairment ◽  
People Living With Hiv ◽  
Lower Likelihood ◽  
Living With Hiv

scholarly journals Prevalence and Correlates of Neurocognitive Disorders among HIV Patients on Antiretroviral Therapy at a Kenyan Hospital

2019 ◽  
Vol 2019 ◽  
pp. 1-10 ◽  
Author(s):  
A. G. Mugendi ◽  
M. N. Kubo ◽  
D. G. Nyamu ◽  
L. M. Mwaniki ◽  
S. K. Wahome ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Clinical Care ◽  
Neurocognitive Impairment ◽  
Neurocognitive Disorders ◽  
Cd4 Count ◽  
People Living With Hiv ◽  
Hiv Diagnosis ◽  
Cross Sectional ◽  
Asymptomatic Neurocognitive Impairment ◽  
Living With Hiv

Background. HIV-associated neurocognitive disorders (HAND) represent a spectrum of cognitive abnormalities affecting attention, concentration, learning, memory, executive function, psychomotor speed, and/or dexterity. Our objectives in this analysis are to determine the prevalence of HAND and the covariates in a Kenyan population. Methods. We conducted a cross-sectional study in a convenient sample of people living with HIV on antiretroviral therapy (ART) attending routine care visits at the Kenyatta National Hospital HIV clinic between July and August 2015. Baseline demographics were obtained using interviewer-administered questionnaires; clinical data were abstracted from patient records. Trained research clinicians determined the neurocognitive status by administration of the International HIV Dementia Scale (IHDS), the Montreal Cognitive Assessment (MOCA) scale, and the Lawton Instrumental Activities of Daily Living (IADL) scale. Cognitive impairment was defined as a score of ≤26 on the MOCA and ≤10 on the IHDS. Descriptive analysis and logistic regression to determine predictors of screening positive for HAND were done with the significance value set at <0.05. Results. We enrolled 345 participants (202 men; 143 women). The mean age of the study population was 42 years (±standard deviation (SD) 9.5). Mean duration since HIV diagnosis and mean duration on ART were 6.3 (±SD 3.7) and 5.6 years (±SD 3.4), respectively. Median CD4 count at interview was 446 cells/mm3 (interquartile range (IQR) 278–596). Eighty-eight percent of participants screened positive for HAND, of whom 87% had asymptomatic neurocognitive impairment (ANI) and minor neurocognitive disorders (MND) grouped together while 1% had HIV-associated dementia (HAD). Patients on AZT/3TC/EFV were 3.7 times more likely to have HAND (OR = 3.7, p=0.03) compared to other HAART regimens. In the adjusted analysis, women were more likely to suffer any form of HAND than men (aOR = 2.17, 95% CI: 1.02, 4.71; p=0.045), whereas more years in school and a higher CD4 count (aOR = 0.58, 95% CI: 0.38, 0.88; p=0.012), (aOR = 0.998, 95% CI 0.997, 0.999; p=0.013) conferred a lowered risk. Conclusion. Asymptomatic and mild neurocognitive impairment is prevalent among people living with HIV on treatment. Clinical care for HIV-positive patients should involve regular screening for neurocognitive disorders while prioritizing women and those with low education and/or low CD4 counts.

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