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Multicenter Study
. 2021 Dec 1;35(15):2469-2480.
doi: 10.1097/QAD.0000000000003057.

Neurocognitive course at 2-year follow-up in a Swiss cohort of people with well-treated HIV

José Damas  1 , Bruno Ledergerber  2 , Isaure Nadin  3 , Philip E Tarr  4 , Marcel Stoeckle  5 , Ursi Kunze  6 , Christoph Hauser  7 , Klemens Gutbrod  8 , Alexandra Calmy  9 , Frédéric Assal  10 , Patrick Schmid  11 , Thomas Hundsberger  12 , Caroline Di Benedetto  13 , Stefania Rossi  14 , Barbara Hasse  2 , Ladina Schlosser  15 , Renaud Du Pasquier  16 , Katharine E A Darling  1 , Matthias Cavassini  1 ; NAMACO study group
Affiliations
Multicenter Study

Neurocognitive course at 2-year follow-up in a Swiss cohort of people with well-treated HIV

José Damas et al. AIDS. .

Abstract

Objective: The aim of this study was to examine neurocognitive course over time among people with well treated HIV.

Design: The Neurocognitive Assessment in the Metabolic and Aging Cohort (NAMACO) study is an ongoing, prospective, longitudinal, multicenter and multilingual study within the Swiss HIV Cohort Study (SHCS). Participants undergo neuropsychological assessment at baseline and two-yearly follow-up.

Setting: Seven SHCS centres.

Participants: Patients aged at least 45 years enrolled in the SHCS with fluency in the local language (French, German or Italian) and agreeing to participate in the NAMACO study: 981 participants at baseline, 720 at 2-year follow-up of whom 644 had complete data sets.

Intervention: Standardized neuropsychological assessment at baseline and 2-year follow-up.

Main outcome measure: Neurocognitive performance using Frascati criteria and mean z-scores.

Results: Four participants (of 644, 0.6%) had plasma HIV-1 RNA more than 50 copies/ml; median CD4+ cell count was 660 cells/μl. According to Frascati criteria, 204 participants (31.7%) had neurocognitive impairment (NCI) at baseline. NCI severity in these participants changed little over 2 years and comprehensive models based on Frascati criteria were not feasible. Examining mean z-scores, however, we observed neurocognitive stability or improvement over two years in five of seven neurocognitive domains assessed. Age at least 65 years (P = 0.02) and cognitive complaints (P = 0.004) were associated with neurocognitive decline, while black race (P = 0.01) and dolutegravir treatment (P = 0.002) were associated with improvement.

Conclusion: Frascati criteria were less sensitive in measuring NCI change and therefore unsuitable for following neurocognitive course in our cohort of people with well treated HIV. Examining neurocognitive course by mean z-score change, we observed stability or improvement.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Fig. 1
Fig. 1
Neurocognitive Assessment in the Metabolic and Aging Cohort (NAMACO) study design.
Fig. 2
Fig. 2
Neurocognitive course from baseline to 2-year follow-up.
Fig. 3
Fig. 3
Clinical and demographic factors associated with neurocognitive change as measured by annualized mean z-scores between baseline and 2-year follow-up in univariable and multivariable linear regression models.
See this image and copyright information in PMC

References

    1. Heaton RK, Clifford DB, Franklin DR, Jr, Woods SP, Ake C, Vaida F, et al. . HIV-associated neurocognitive disorders persist in the era of potent antiretroviral therapy: CHARTER Study. Neurology 2010; 75:2087–2096. - PMC - PubMed
    1. Simioni S, Cavassini M, Annoni JM, Rimbault Abraham A, Bourquin I, Schiffer V, et al. . Cognitive dysfunction in HIV patients despite long-standing suppression of viremia. AIDS 2010; 24:1243–1250. - PubMed
    1. Metral M, Darling K, Locatelli I, Nadin I, Santos G, Brugger P, et al. . The Neurocognitive Assessment in the Metabolic and Aging Cohort (NAMACO) study: baseline participant profile. HIV Med 2020; 21:30–42. - PMC - PubMed
    1. Underwood J, De Francesco D, Leech R, Sabin CA, Winston A, Pharmacokinetic and Clinical Observations in PeoPle Over FiftY (POPPY) Study. Medicalising normality? Using a simulated dataset to assess the performance of different diagnostic criteria of HIV-associated cognitive impairment. PLoS One 2018; 13:e0194760. - PMC - PubMed
    1. Gisslen M, Price RW, Nilsson S. The definition of HIV-associated neurocognitive disorders: are we overestimating the real prevalence?. BMC Infect Dis 2011; 11:356. - PMC - PubMed

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