Screening for Neurocognitive Impairment in HIV-Infected Individuals at First Contact after HIV Diagnosis: The Experience of a Large Clinical Center in Northern Italy

Int J Mol Sci. 2016 Mar 24;17(4):434. doi: 10.3390/ijms17040434.

Abstract

Neurocognitive disorders are emerging, probably underestimated, complications in HIV-infected people. The aim of the study was to assess neurocognitive profiles of newly detected HIV-infected patients. We performed an observational retrospective single-cohort study. Illiterates and patients with neurologic symptoms or previous psychiatric diagnosis were excluded. Neuropsychological profiles were assessed using a validated battery of neuropsychological tests. We included 206 patients; with males representing the majority of them (85%). Risk factors for HIV acquisition were unprotected sexual intercourse (homo/bisexual in 39.8% and heterosexual in 60.2%). Thirty-nine patients (18.9%) were previous injection drug users, while 41 (19.9%) were alcohol abusers. Mean education was 11.1 years (SD--standard deviation--3.7). A high prevalence of HIV-associated neurocognitive disorders (HAND, 47.1%) was present in HIV-infected patients: particularly, asymptomatic neurocognitive impairment (ANI) was found in 30.6%, mild neurocognitive disorder (MND) in 15% and HIV-associated dementia (HAD) in 1.5%. Male gender, low degree of education, AIDS diagnosis and gepatitis B virus (HBV) co-infection were factors independently associated with HAND in a multivariable logistic regression model. Our data suggest that patient-specific factors and AIDS diagnosis have a certain kind of impact in HAND occurrence. A complete neuropsychological screening must be recommended in all patients at HIV-infection diagnosis.

Keywords: HIV; HIV-associated dementia; neurocognitive disorders.

MeSH terms

  • Adult
  • Alcoholism / complications
  • Cohort Studies
  • Coinfection / complications
  • Coinfection / diagnosis
  • Female
  • HIV Infections / complications
  • HIV Infections / diagnosis*
  • Hepatitis B / complications
  • Hepatitis B / diagnosis
  • Humans
  • Italy
  • Logistic Models
  • Male
  • Middle Aged
  • Neurocognitive Disorders / epidemiology
  • Neurocognitive Disorders / etiology*
  • Neuropsychological Tests
  • Prevalence
  • Proportional Hazards Models
  • Retrospective Studies
  • Risk Factors
  • Substance-Related Disorders / complications