Cognitive Impairment Among HIV-positive Individuals in a Tertiary Infectious Disease Hospital in the Philippines
Joseree-Ann S. Catindig, France Gil B. Rasay, Melmar C. Folloso, Rosario Jessica T. Abrenica
Oct 2022 DOI 10.35460/2546-1621.2022-0043 Access
Abstract
Background: Disruption of neurocognitive functioning is one of the most frequent complications in patients infected with Human immunodeficiency virus. It manifests as a form of subcortical dementia characterized by psychomotor slowing, changes in mood and anxiety levels and deficits in memory, abstraction, information processing, verbal fluency, decision-making, and attention. The primary objective of this study is to determine the prevalence of neurocognitive impairment among HIV-positive individuals in the Philippines.
Methods: This is a cross-sectional study done at the outpatient department of a tertiary infectious disease hospital located in Manila, Philippines conducted from May to July 2015. The Montreal Cognitive Assessment – Filipino (MoCA-P) was used to differentiate non-cognitively impaired and cognitively impaired participants. Demographic data was obtained using structured interviews including the CD4 count.
Results: One hundred and twelve HIV positive patients were examined and 56.7% of them were noted to have cognitive impairment while none of them met the criteria for dementia. After logistics regression analysis, only the CD4 count (x=224) was shown to have significant association with cognitive impairment (p=0.0001, OR 0.96).
Conclusion: Cognitive impairment was significantly associated with low CD4 count, with a sensitivity of 100% for a count of <224. More than half or 58.7% of subjects with cognitive impairment did not show any neuropsychiatric symptoms. Neurocognitive impairment is still an important component of HIV infection and this study highlights the need to further increase awareness regarding this HIV complication.
Key words: cognitive impairment; HIV; dementia; HAND
- Mind Exchange Working Group. Assessment, diagnosis, and treatment of HIV-associated neurocognitive disorder: a consensus report of the mind exchange program. Clin Infect Dis [Internet]. 2013;56(7):1004–17. Available from: http://dx.doi.org/10.1093/cid/cis975
- Grant I. Neurocognitive disturbances in HIV. Int Rev Psychiatry [Internet]. 2008;20(1):33–47. Available from: http://dx.doi.org/10.1080/09540260701877894
- Spudich S, González-Scarano F. HIV-1-related central nervous system disease: current issues in pathogenesis, diagnosis, and treatment. Cold Spring Harb Perspect Med [Internet]. 2012;2(6):a007120. Available from: http://dx.doi.org/10.1101/cshperspect.a007120
- González-Scarano F, Martín-García J. The neuropathogenesis of AIDS. Nat Rev Immunol [Internet]. 2005;5(1):69–81. Available from: http://dx.doi.org/10.1038/nri1527
- Portegies P, Enting RH, de Gans J, Algra PR, Derix MM, Lange JM, et al. Presentation and course of AIDS dementia complex: 10 years of follow-up in Amsterdam, The Netherlands. AIDS. 1993;7(5):669–75.
- STD/AIDS Cooperative Central Laboratory (SACCL) October 2013.
- McArthur JC. HIV dementia: an evolving disease. J Neuroimmunol [Internet]. 2004;157(1–2):3–10. Available from: http://dx.doi.org/10.1016/j.jneuroim.2004.08.042
- Galvin JE, Sadowsky CH, NINCDS-ADRDA. Practical guidelines for the recognition and diagnosis of dementia. J Am Board Fam Med [Internet]. 2012;25(3):367–82. Available from: http://dx.doi.org/10.3122/jabfm.2012.03.100181
- Lawton MP, Brody EM. Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist. 1969 Autumn;9(3):179–86.
- Cummings JL. The Neuropsychiatric Inventory: assessing psychopathology in dementia patients. Neurology [Internet]. 1997;48(5 Suppl 6):S10-6. Available from: http://dx.doi.org/10.1212/wnl.48.5_suppl_6.10s
- Mind Exchange Working Group. Assessment, diagnosis, and treatment of HIV-associated neurocognitive disorder: a consensus report of the mind exchange program. Clin Infect Dis [Internet]. 2013;56(7):1004–17. Available from: http://dx.doi.org/10.1093/cid/cis975
- Neurologic Complications of HIV and Antiretroviral therapy, Duarte et al., the PRN notebook October 200, published in New York City by the Physicians Res Our reach network Inc.
- Ropper A, Samuels M, Klein J. Adams and Victor’s Principles of Neurology. 10th ed. New York, NY: McGraw-Hill Medical; 2014.
- Sidtis JJ, Gatsonis C, Price RW, Singer EJ, Collier AC, Richman DD, et al. Zidovudine treatment of the AIDS dementia complex: Results of a placebo-controlled trial. Ann Neurol [Internet]. 1993;33(4):343–9. Available from: http://dx.doi.org/10.1002/ana.410330403
- Valcour V, Paul R, Chiao S, Wendelken LA, Miller B. Screening for cognitive impairment in human immunodeficiency virus. Clin Infect Dis [Internet]. 2011;53(8):836–42. Available from: http://dx.doi.org/10.1093/cid/cir524
- Watkins C, Treisman G. Cognitive impairment in patients with AIDS – prevalence and severity. HIV AIDS (Auckl) [Internet]. 2015;35. Available from: http://dx.doi.org/10.2147/hiv.s39665
Articles related to the one you are viewing
There are currently no results to show, please try again later
Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License, which permits use, share — copy and redistribute the material in any medium or format, adapt — remix, transform, and build upon the material, as long as you give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use. You may not use the material for commercial purposes. If you remix, transform, or build upon the material, you must distribute your contributions under the same license as the original. You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit https://creativecommons.org/licenses/by-nc-sa/4.0/.