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

• Published in: AIDS and behavior 2018-05, Vol.22 (5), p.1573-1583
• Main Authors: Haddow, Lewis J., Laverick, Rosanna, Daskalopoulou, Marina, McDonnell, Jeffrey, Lampe, Fiona C., Gilson, Richard, Speakman, Andrew, Antinori, Andrea, Balestra, Pietro, Bruun, Tina, Gerstoft, Jan, Nielsen, Lars, Vassilenko, Anna, Collins, Simon, Rodger, Alison J.
• Format: Article
• Language: English
• Subjects: Acquired immune deficiency syndrome; Activities of Daily Living; Aged; AIDS; AIDS Dementia Complex - diagnosis; AIDS Dementia Complex - drug therapy; AIDS Dementia Complex - epidemiology; Ambulatory Care Facilities; Anti-HIV Agents - therapeutic use; Antiretroviral agents; Antiretroviral drugs; Antiretroviral therapy; Basic needs; CD4 antigen; CD4 Lymphocyte Count; Cognition; Cognition Disorders - epidemiology; Cognition Disorders - etiology; Cognition Disorders - psychology; Cognitive ability; Colleges & universities; Confidence intervals; Cross-Sectional Studies; Dementia; Denmark - epidemiology; Female; Health Psychology; HIV; HIV Infections - complications; HIV Infections - drug therapy; HIV Infections - psychology; HIV Seropositivity - complications; Human immunodeficiency virus; Humans; Impairment; Infectious Diseases; Italy - epidemiology; London - epidemiology; Male; Medicine; Medicine & Public Health; Mental depression; Middle Aged; Neurology; Neuropsychological Tests; Original Paper; Patients; People with disabilities; Prescription drugs; Prevalence; Public Health; Republic of Belarus - epidemiology; Symptoms
• ISSN: 1090-7165; 1573-3254
• DOI: 10.1007/s10461-017-1683-z

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/mm 3 ; 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).