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Cognitive dysfunction in HIV patients despite long-standing suppression of viremia

Cavassini, Matthias
Rimbault Abraham, Aline
Bourquin, Isabelle
Schiffer, Veronique
Chave, Jean-Philippe
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Published in AIDS. 2010, vol. 24, no. 9, p. 1243-1250
Abstract OBJECTIVE: To determine the prevalence of cognitive complaints and HIV-associated neurocognitive disorders (HANDs) in a cohort of aviremic HIV-positive patients. To evaluate the relevance of the HIV dementia scale to detect HANDs. DESIGN: Assessment of HANDs with neuropsychological tests. METHODS: Two hundred HIV-infected patients with undetectable HIV-1 RNA concentrations in the plasma, no history of major opportunistic infection of the central nervous system in the past 3 years, no current use of intravenous drugs, and no major depression answered a questionnaire designed to elicit cognitive complaints. Cognitive functions of 50 complaining and 50 noncomplaining HIV-positive patients were assessed. RESULTS: Patients had undetectable HIV-1 RNA concentrations for a median time of 48 months (range 3.2-136.6). The prevalence of cognitive complaints was 27%. The prevalence of HANDs was 84% among patients with cognitive complaints (asymptomatic neurocognitive impairment 24%, mild neurocognitive disorders 52%, and HIV-associated dementia 8%) and 64% among noncomplainers (asymptomatic neurocognitive impairment 60%, mild neurocognitive disorders 4%, and HIV-associated dementia 0%; P < 0.001). A score of 14 points or less on the HIV dementia scale yielded a positive predictive value of HANDs of 92% in complainers and 82% in noncomplainers. CONCLUSION: The prevalence of HANDs is high even in long-standing aviremic HIV-positive patients. However, HANDs without functional repercussion in daily life (asymptomatic neurocognitive impairment) is the most frequent subtype observed. In this population, the HIV dementia scale with a cutoff of 14 points or less seems to provide a useful tool to screen for the presence of HANDs.
Keywords AdultAgedCognition Disorders/*epidemiology/etiologyFemaleFrance/epidemiologyHIV Infections/epidemiology/*psychology*HIV-1/geneticsHumansMaleMiddle AgedNeuropsychological TestsPrevalenceQuestionnairesRNA, Viral/bloodSwitzerland/epidemiologyViremia/*prevention & control
PMID: 19996937
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Research group Unité HIV (46)
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SIMIONI, Samanta et al. Cognitive dysfunction in HIV patients despite long-standing suppression of viremia. In: AIDS, 2010, vol. 24, n° 9, p. 1243-1250. doi: 10.1097/QAD.0b013e3283354a7b https://archive-ouverte.unige.ch/unige:21312

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Deposited on : 2012-05-23

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