Tags

Type your tag names separated by a space and hit enter

Neurocognitive Impairment in Well-Controlled HIV-Infected Patients: A Cross-Sectional Study.
AIDS Res Hum Retroviruses 2019; 35(7):634-641AR

Abstract

The reported prevalence of HIV-associated neurocognitive disorders in HIV people depends on the population studied and the methodology used. We analyze the prevalence of neurocognitive impairment (NCI) and associated factors in patients on successful antiretroviral therapy (ART), without comorbidities. Cross-sectional observational study in HIV subjects, ≥18 years old, on stable ART, and HIV viral load of <50 copies/mL. Patients with medical or psychiatric comorbidities and substance abuse were excluded. NCI was diagnosed using Frascati criteria, examining seven neurocognitive domains (NDs). We analyzed the association between NCI and HIV-related clinical variables, carotid intima-media thickness, bacterial translocation, and plasma inflammatory biomarkers [soluble CD14, interleukin-6 (IL-6), and tumor necrosis factor-α]. The prevalence of NCI was calculated with a 95% confidence interval (CI). We fitted a logistic regression model to assess the strength of the associations. Eighty-four patients were included with an observed NCI prevalence of 29.8% (95% CI: 21.0-40.2): 19% had asymptomatic NCI, 8.3% had mild neurocognitive disorder, and 2.4% had HIV-associated dementia. Delayed recall was the most commonly affected ND (27.4%). People diagnosed at least 10 years ago (odds ratio [OR]: 6.5, 95% CI: 1.6-21.7) and those with IL-6 levels above 1.8 pg/mL (OR: 6.0, 95% CI: 1.1-31.3) showed higher odds of NCI in adjusted analyses. Participants with carotid plaques had lower scores for delayed recall: -0.9 ± 1.1 versus -0.2 ± 1.1 (p = .04). Prevalence of NCI is high in otherwise healthy adults with HIV-infection. In this population, more than 10 years since HIV diagnosis and high IL-6 levels are associated with NCI. Delayed recall ND is worse in patients with subclinical atherosclerosis.

Authors+Show Affiliations

1 Department of Infectious Diseases, General University Hospital of Alicante, Alicante, Spain. 2 HIV and Infectious Diseases Researching Group, Institute for Health and Biomedical Research (ISABIAL-FISABIO Foundation), Alicante, Spain. 3 Department of Health Psychology, Alicante University, Alicante, Spain.1 Department of Infectious Diseases, General University Hospital of Alicante, Alicante, Spain. 2 HIV and Infectious Diseases Researching Group, Institute for Health and Biomedical Research (ISABIAL-FISABIO Foundation), Alicante, Spain. 4 Department of Clinical Medicine, Miguel Hernández University, Alicante, Spain.1 Department of Infectious Diseases, General University Hospital of Alicante, Alicante, Spain.2 HIV and Infectious Diseases Researching Group, Institute for Health and Biomedical Research (ISABIAL-FISABIO Foundation), Alicante, Spain. 5 Department of Clinical Psychology, General University Hospital of Alicante, Alicante, Spain. 6 Department of Health Psychology, Miguel Hernández University, Alicante, Spain.2 HIV and Infectious Diseases Researching Group, Institute for Health and Biomedical Research (ISABIAL-FISABIO Foundation), Alicante, Spain. 7 Department of Epidemiology and Public Health, General University Hospital of Alicante, Alicante, Spain.2 HIV and Infectious Diseases Researching Group, Institute for Health and Biomedical Research (ISABIAL-FISABIO Foundation), Alicante, Spain. 8 Department of Neurology, General University Hospital of Alicante, Alicante, Spain.1 Department of Infectious Diseases, General University Hospital of Alicante, Alicante, Spain. 2 HIV and Infectious Diseases Researching Group, Institute for Health and Biomedical Research (ISABIAL-FISABIO Foundation), Alicante, Spain. 4 Department of Clinical Medicine, Miguel Hernández University, Alicante, Spain.1 Department of Infectious Diseases, General University Hospital of Alicante, Alicante, Spain. 2 HIV and Infectious Diseases Researching Group, Institute for Health and Biomedical Research (ISABIAL-FISABIO Foundation), Alicante, Spain.1 Department of Infectious Diseases, General University Hospital of Alicante, Alicante, Spain. 2 HIV and Infectious Diseases Researching Group, Institute for Health and Biomedical Research (ISABIAL-FISABIO Foundation), Alicante, Spain. 3 Department of Health Psychology, Alicante University, Alicante, Spain.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30880401

Citation

Portilla, Irene, et al. "Neurocognitive Impairment in Well-Controlled HIV-Infected Patients: a Cross-Sectional Study." AIDS Research and Human Retroviruses, vol. 35, no. 7, 2019, pp. 634-641.
Portilla I, Reus S, León R, et al. Neurocognitive Impairment in Well-Controlled HIV-Infected Patients: A Cross-Sectional Study. AIDS Res Hum Retroviruses. 2019;35(7):634-641.
Portilla, I., Reus, S., León, R., van-der Hofstadt, C., Sánchez, J., López, N., ... Portilla, J. (2019). Neurocognitive Impairment in Well-Controlled HIV-Infected Patients: A Cross-Sectional Study. AIDS Research and Human Retroviruses, 35(7), pp. 634-641. doi:10.1089/AID.2018.0279.
Portilla I, et al. Neurocognitive Impairment in Well-Controlled HIV-Infected Patients: a Cross-Sectional Study. AIDS Res Hum Retroviruses. 2019;35(7):634-641. PubMed PMID: 30880401.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Neurocognitive Impairment in Well-Controlled HIV-Infected Patients: A Cross-Sectional Study. AU - Portilla,Irene, AU - Reus,Sergio, AU - León,Rafael, AU - van-der Hofstadt,Carlos, AU - Sánchez,José, AU - López,Nicolás, AU - Boix,Vicente, AU - Merino,Esperanza, AU - Portilla,Joaquín, Y1 - 2019/04/16/ PY - 2019/3/19/pubmed PY - 2019/3/19/medline PY - 2019/3/19/entrez KW - HIV KW - bacterial translocation KW - delayed recall KW - interleukin-6 KW - neurocognitive impairment KW - subclinical atherosclerosis SP - 634 EP - 641 JF - AIDS research and human retroviruses JO - AIDS Res. Hum. Retroviruses VL - 35 IS - 7 N2 - The reported prevalence of HIV-associated neurocognitive disorders in HIV people depends on the population studied and the methodology used. We analyze the prevalence of neurocognitive impairment (NCI) and associated factors in patients on successful antiretroviral therapy (ART), without comorbidities. Cross-sectional observational study in HIV subjects, ≥18 years old, on stable ART, and HIV viral load of <50 copies/mL. Patients with medical or psychiatric comorbidities and substance abuse were excluded. NCI was diagnosed using Frascati criteria, examining seven neurocognitive domains (NDs). We analyzed the association between NCI and HIV-related clinical variables, carotid intima-media thickness, bacterial translocation, and plasma inflammatory biomarkers [soluble CD14, interleukin-6 (IL-6), and tumor necrosis factor-α]. The prevalence of NCI was calculated with a 95% confidence interval (CI). We fitted a logistic regression model to assess the strength of the associations. Eighty-four patients were included with an observed NCI prevalence of 29.8% (95% CI: 21.0-40.2): 19% had asymptomatic NCI, 8.3% had mild neurocognitive disorder, and 2.4% had HIV-associated dementia. Delayed recall was the most commonly affected ND (27.4%). People diagnosed at least 10 years ago (odds ratio [OR]: 6.5, 95% CI: 1.6-21.7) and those with IL-6 levels above 1.8 pg/mL (OR: 6.0, 95% CI: 1.1-31.3) showed higher odds of NCI in adjusted analyses. Participants with carotid plaques had lower scores for delayed recall: -0.9 ± 1.1 versus -0.2 ± 1.1 (p = .04). Prevalence of NCI is high in otherwise healthy adults with HIV-infection. In this population, more than 10 years since HIV diagnosis and high IL-6 levels are associated with NCI. Delayed recall ND is worse in patients with subclinical atherosclerosis. SN - 1931-8405 UR - https://www.unboundmedicine.com/medline/citation/30880401/Neurocognitive_Impairment_in_Well_Controlled_HIV_Infected_Patients:_A_Cross_Sectional_Study_ L2 - https://www.liebertpub.com/doi/full/10.1089/AID.2018.0279?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -