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. 2018 May;22(5):1573-1583.
doi: 10.1007/s10461-017-1683-z.

Multicenter European Prevalence Study of Neurocognitive Impairment and Associated Factors in HIV Positive Patients

Lewis J Haddow  1 , Rosanna Laverick  2 , Marina Daskalopoulou  2 , Jeffrey McDonnell  3 , Fiona C Lampe  2 , Richard Gilson  2 , Andrew Speakman  2 , Andrea Antinori  4 , Pietro Balestra  4 , Tina Bruun  5 , Jan Gerstoft  5 , Lars Nielsen  6 , Anna Vassilenko  7 , Simon Collins  8 , Alison J Rodger  2 ; Cognitive Impairment in People with HIV in the European Region (CIPHER) Study Group
Affiliations

Multicenter European Prevalence Study of Neurocognitive Impairment and Associated Factors in HIV Positive Patients

Lewis J Haddow et al. AIDS Behav. 2018 May.

Abstract
in English, Spanish

We conducted a cross-sectional study in 448 HIV positive patients attending five European outpatient clinics to determine prevalence of and factors associated with neurocognitive impairment (NCI) using computerized and pen-and-paper neuropsychological tests. NCI was defined as a normalized Z score ≤-1 in at least 2 out of 5 cognitive domains. Participants' mean age was 45.8 years; 84% male; 87% white; 56% university educated; median CD4 count 550 cells/mm3; 89% on antiretroviral therapy. 156 (35%) participants had NCI, among whom 26 (17%; 5.8% overall) reported a decline in activities of daily living. Prevalence of NCI was lower in those always able to afford basic needs (adjusted prevalence ratio [aPR] 0.71, 95% confidence interval [CI] 0.54-0.94) or with a university education (aPR 0.72, 95% CI 0.54-0.97) and higher in those with severe depressive symptoms (aPR 1.53, 95% CI 1.09-2.14) or a significant comorbid condition (aPR 1.40, 95% CI 1.03-1.90).

Reportamos un estudio de tipo corte transversal que incluye 448 pacientes VIH seropositivos vistos en cinco clínicas especializadas en Europa con el objetivo de medir la prevalencia del trastorno neurocognitivo asociado al VIH (NCI por sus siglas en inglés) y los factores de riesgo asociados a éste. Se usaron pruebas neuropsicológicas computarizadas y en papel para determinar la presencia de NCI, definido como puntuación Z ≤ 1 en al menos 2 de los 5 dominios cognitivos evaluados. La media de edad de los pacientes fue 45,8 años, 84% eran hombres, 87% blancos y 56% tenían educación universitaria. La media de CD4 fue de 550 cel/mm3 y 89% de los pacientes recibían terapia antiretroviral. Un total de 156 (35%) participantes tenían NCI, de los cuales 26 (17%, 5,8% de la población de estudio) reportaron deterioro en actividades de la vida diaria. La prevalencia de NCI fue menor en participantes capaces de cubrir sus necesidades básicas (Razón de prevalencia ajustada [aPR] 0,71; Intervalo de confianza del 95% [95% CI] 0,54-0,94) o con educación universitaria (aPR 0,72; 95%CI 0,54-0,97) pero fue mayor en aquellos con síntomas de depresión severa (aPR 1,53; 95%CI 1,09-2,14) o alguna comorbilidad importante (aPR 1,40; 95%CI 1,03-1,90).

Keywords: Activities of daily living; HIV; HIV dementia; MCI (mild cognitive impairment); Neuropsychological assessment; Prevalence.

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Conflict of interest statement

Conflict of interest

The authors report no disclosures.

Ethical Approval

The study was approved by the UK National Research Ethics Service—London Hampstead Committee (11/LO/0077), De Videnskabsetiske Komiteér for Region Hovedstaden (H-4-2011-105), the Ethics Committee of the Minsk Municipal Infectious Diseases Hospital (04/2011), and the Comitato Etico of Istituto Nazionale Malattie Infettive (66/2011). All study participants gave written informed consent prior to commencing the study.

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