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Cognitive dysfunction in HIV patients despite long-standing suppression of viremia

Authors

Simioni, Samanta, Cavassini, Matthias, Annoni, Jean-Marie, Rimbault Abraham, Aline, Bourquin, Isabelle, Schiffer, Véronique, Calmy, Alexandra, Chave, Jean-Philippe, Giacobini, Ezio, Hirschel, Bernard, Du Pasquier, Renaud A.

Journal

AIDS (London, England), Volume: 24, No.: 9, Pages.: 1243-1250

Year of Publication

2010

Abstract

Objective: To determine the prevalence of cognitive complaints and HIV-associated neurocognitive disorders (HANDs) in a cohort of aviremic HIV-positive patients. To evaluate the relevance of the HIV dementia scale to detect HANDs.; Design: Assessment of HANDs with neuropsychological tests.; Methods: Two hundred HIV-infected patients with undetectable HIV-1 RNA concentrations in the plasma, no history of major opportunistic infection of the central nervous system in the past 3 years, no current use of intravenous drugs, and no major depression answered a questionnaire designed to elicit cognitive complaints. Cognitive functions of 50 complaining and 50 noncomplaining HIV-positive patients were assessed.; Results: Patients had undetectable HIV-1 RNA concentrations for a median time of 48 months (range 3.2-136.6). The prevalence of cognitive complaints was 27%. The prevalence of HANDs was 84% among patients with cognitive complaints (asymptomatic neurocognitive impairment 24%, mild neurocognitive disorders 52%, and HIV-associated dementia 8%) and 64% among noncomplainers (asymptomatic neurocognitive impairment 60%, mild neurocognitive disorders 4%, and HIV-associated dementia 0%; P < 0.001). A score of 14 points or less on the HIV dementia scale yielded a positive predictive value of HANDs of 92% in complainers and 82% in noncomplainers.; Conclusion: The prevalence of HANDs is high even in long-standing aviremic HIV-positive patients. However, HANDs without functional repercussion in daily life (asymptomatic neurocognitive impairment) is the most frequent subtype observed. In this population, the HIV dementia scale with a cutoff of 14 points or less seems to provide a useful tool to screen for the presence of HANDs.;

Bibtex Citation

@article{Simioni_2009, doi = {10.1097/qad.0b013e3283354a7b}, url = {http://dx.doi.org/10.1097/QAD.0b013e3283354a7b}, year = 2009, month = {dec}, publisher = {Ovid Technologies (Wolters Kluwer Health)}, pages = {1}, author = {Samanta Simioni and Matthias Cavassini and Jean-Marie Annoni and Aline Rimbault Abraham and Isabelle Bourquin and V{'{e}}ronique Schiffer and Alexandra Calmy and Jean-Philippe Chave and Ezio Giacobini and Bernard Hirschel and Renaud A Du Pasquier}, title = {Cognitive dysfunction in {HIV} patients despite long-standing suppression of viremia}, journal = {{AIDS}} }

Keywords

adult, aged, associated, blood, cognition disorders, dementia, diagnosis, epidemiology, etiology, female, france, genetics, hiv, hiv infections, hiv1, humans, male, middle aged, neuropsychological tests, prevalence, prevention & control, psychology, questionnaires, rna viral, switzerland, viremia

Countries of Study

Switzerland

Types of Dementia

Mild Cognitive Impairment (MCI)

Types of Study

Cohort Study

Type of Outcomes

Other

Type of Interventions

Diagnostic Target Identification

Diagnostic Targets

Cognition testing (inc. task driven tests such as clock drawing)