HIV-associated neurocognitive disorder among long-term HIV/AIDS patients under antiretroviral therapy at Bach Mai Hospital

https://doi.org/10.52322/jocmbmh.07.en.08

Introduction: HIV-associated neurocognitive disorder (HAND) encompasses a range of neurological complications related to HIV infection, including HIV-related asymptomatic neurocognitive impairment (ANI), HIV-induced moderate neurocognitive dysfunction (MND), and HIV-associated dementia (HAD).

Objectives: This study assessed the prevalence of HAND and influenced factors in a large sample of long-term HIV/AIDS patients under ART at Center for Tropical Diseases, Bach Mai Hospital.

Material and Methods: We conducted a cross-sectional study from August to October 2015 among 958 HIV positive patients. Patients was self-reported about their level of HIV-associated dementia (HAD) by using The International HIV Dementia Scale (IHDS). Grooved Pegboard Test was also employed to screen for ANI among respondents.

Results: The mean age of enrolled patients was 38.1 ± 8.5 years old, with the majority was male (61.4%). There were about 39.04%, 19.21%, and 8.04% of patients reported the symptoms of memory loss, slow-thinking, and difficulty in concentrating, respectively. Using IHDS, we found about 54% of patients has considered as having HAD (cut-off of IHDS total score < or = 10).  The mean Grooved Pegboard Test score for left-handed patients was 93.48 (SD=14.47), and for right-handed patients was 89.56 (SD=14.5). Compared to reference points, the estimation of patients having ANI was relatively low at 0.42%. Older age and female were more likely to have HAND symptoms and HAD than male and younger patients. Patients with history of injection drugs had higher risk of HAND. Patients under antiretroviral treatment with ABC-based regimen was associated with HAND than TDF-based and AZT-based regimen.

Conclusion: Our findings found that the prevalence of symptoms and HIV-associated dementia were relatively high. We suggested co-providing mental health counselling and treatment services with ART is necessary for people living with HIV.

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