HIV and dementia: prevalence and risk factors

Authors

  • Lara GF Távora Universidade de Fortaleza Hospital São José de Doenças Infecciosas
  • Thais Martins Figueiredo Universidade de Fortaleza
  • Ramille Moitas Krammer de Mesquita Universidade de Fortaleza
  • Fernando Ricarte Bezerra Universidade de Fortaleza
  • Bruno Pinheiro Aquino Universidade de Fortaleza
  • Jeová Keny de Baima Colares Universidade de Fortaleza Hospital São José de Doenças Infecciosas

DOI:

https://doi.org/10.5020/18061230.2016.p212

Keywords:

AIDS Dementia Complex, Acquired Immunodeficiency Syndrome, Neurocognitive Disorders.

Abstract

Objective: To determine the prevalence of patients at risk of developing HIV-associated neurocognitive disorder (HAND) and identify factors possibly associated with its occurence. Methods: Quantitative cross-sectional study conducted at the Specialized Care Service (Serviço de Atendimento Especializado - SAE) for HIV/Aids of the Integrated Medical Care Center (Núcleo de Atendimento Médico Integrado - NAMI) of the University of Fortaleza (Universidade de Fortaleza - UNIFOR), Fortaleza, Ceará, Brazil. We reviewed medical records of all 249 patients that started medical follow-up at SAE/NAMI since its foundation (August/2010) until January/2014, including in the analysis those who completed the international HIV dementia scale - IHDS during routine medical visits. Epidemiological, clinical and laboratory variables were collected in addition to IHDS score and the sample was classified in two groups: patients with IHDS≥10 (Group 1) and IHDS<10 (Group 2). Chisquared test was used for categorical variables and student t test, mann whitney test and linear regression were used for numerical variables. Results: The study population consisted of 178 patients with mean IHDS score of 9.5 (+/- 1.6). HAND prevalence was 41.6% (74/178) (IHDS<10). These patients presented older mean age (37.4 years) and longer mean time from HIV diagnosis to medical follow-up than the others (10.1 months) when compared to Group 2 (31 years old and 4.6 months, respectively), suggesting that these two variables were possibly associated with HAND occurrence. Conclusion: The IHDS application showed a high prevalence of HAND in the study population. More advanced age and longer time from HIV diagnosis to medical follow-up are possibly associated with its occurence.

Downloads

Download data is not yet available.

Author Biography

Lara GF Távora, Universidade de Fortaleza Hospital São José de Doenças Infecciosas

Professora adjunto do Curso de Medicina da Universidade de Fortaleza Preceptora do Programa de Residência Médica em Infectologia do Hospital São José de Doenças Infecciosas

References

World Health Organization – WHO. Global Health Observatory (GHO) data about HIV/AIDS. Who; 2015 [accessed on 2015 Apr 26]. Available from: http:// www.who.int/gho/hiv/en/

Ministério da Saúde (BR), Secretaria de Vigilância em Saúde, Departamento de DST, Aids e Hepatites Virais. Boletim epidemiológico HIV/Aids. Brasília: Ministério da Saúde; 2014.

Tedaldi EM, Minniti NL, Fischer T. HIV-associated neurocognitive disorders: the relationship of HIV infection with physical and social comorbidities. Biomed Res Int. 2015;2015:641913.

Letendre SL, Ellis RJ, Everall I, Ances B, Bharti A, McCutchan JA. Neurologic complications of HIV disease and their treatment. Top HIV Med. 2009;17(2):46-56.

Singer EJ, Sueiras MV, Commins D, Levin EA. Neurologic presentation of AIDS. Neurol Clin. 2010;28(1):253-7.

Ganasen KA, Fincham D, Smit J, Seedat S, Stein D. Utility of the HIV Dementia Scale (HDS) in identifying HIV dementia in a South African sample. J Neurol Sci.2008;269(1-2):62-4.

MCarthur JC. HIV dementia: an evolving disease. J Neuroimmunol. 2004;157(1-2):3-10.

Ho EL, Jay CA. Altered mental status in HIV: infected patients. Emergency Medicine Clinics of North America. 2010;28(2):311-23.

MCarthur JC, Hoover DR, Bacellar H, Miller EN, Cohen BA, Becker JT, et al. Dementia in Aids patients: incidence and risk factors. Multicenter AIDS Cohort Study. Neurology. 1993;43(11):2245-52.

Fernandes Filho SMM, Melo HRL. Frequency and risk factors for HIV associated neurocognitive disorder and depression in older individuals with HIV in northeastern Brazil. International Psychogeriatrics. 2012;24(10):1648-55.

Sacktor NC, Wong M, Nakasujja N, Skolasky RL, Selnes OA, Musisi S, et al. The International HIV Dementia Scale: a new rapid screening test for HIV dementia. AIDS. 2005;19(13):1367-74.

Lyon ME, MCCarter R, D’Angelo LJ. Detecting HIV associated neurocognitive disorders in adolescentes: what is the best screening tool? Journal of adolescent health. 2009;44(2):133-5.

Rodrigues RA, Oliveira RL, Grinsztejn B, Silva MTT. Validity of the International HIV Dementia Scale in Brazil. Arq Neuropsiquiatr. 2013;71(6):376-9.

Grant I, Franklin JR. DR, Deutsch R, Woods SP, Vaida F, Ellis RJ, et al. Neurology. 2014;82:2055–2062.

Heaton RK, Clifford D, Franklin DR, Woods SP, Ake C, Vaida F, et al. HIV-associated neurocognitive disorders persist in the era of potent antiretroviral therapy: CHARTER Study. Neurology. 2010;75(23):2087-96.

Clifford DB, Ances BM. HIV-associated neurocognitive disorder. Lancet Infect Dis. 2013;13(11):976-86.

Oliveira MF, Murrel B, Pérez-Santiago J, Vargas M, Ellis RJ, Letendre S, et al. Circulating HIV DNA correlates with neurocognitive impairment in older HIV-infected adults on suppressive ART. Sci Rep. 2015;5:17094.

Rao VR, Ruiz AP, Prasad VR. Viral and cellular factors underlying neuropathogenesis in HIV associated neurocognitive disorders (HAND). AIDS Res Ther. 2014;11:13.

Ellis RJ, Badiee J, Vaida F, Letendre S, Heaton RK, Clifford D, et al. CD4 nadir is a predictor of HIV neurocognitive impairment in the era of combination antiretroviral therapy. AIDS. 2011;25(14):1747-51.

Zhang Y, Qiao L, Ding W, Wei F, Zhao Q, Wang X, et al. An initial screening for HIV-associated neurocognitive disorders of HIV-1 infected patients in China. J Neurovirol. 2012;18(2):120-6.

Simioni S, Cavassini M, Annoni J, Abraham AR, Bourquin I, Schiffer V, et al. Cognitive dysfunction in HIV patients despite long-standing suppression of viremia. AIDS. 2010;24(9):1243-50.

Calcagno A, Simiele M, Alberione MC, Bracchi M, Marinaro L, Ecclesia S, et al. Cerebrospinal fluid inhibitory quotients of antiretroviral drugs in HIVinfected patients are associated with compartmental viral control. Clin Infect Dis. 2015;60(2):311-7.

Bryant AK, Ellis RJ, Umlauf A, Gouaux B, Soontornniyomkij V, Letendre SL, et al. Antiretroviral therapy reduces neurodegeneration in human immunodeficiency virus infection AIDS. 2015;29(3):323–30.

Zayyad Z, Spudich S. Neuropathogenesis of HIV: from initial neuroinvasion to HIV Associated Neurocognitive Disorder (HAND). Curr HIV/AIDS Rep. 2015;12(1):16-24.

Boisse ́ L, Gill MJ, Power C. HIV infection of the Central Nervous System: clinical features and neuropathogenesis. Neurol Clin. 2008;26(3):799-819.

Tavazzi E, Morrison D, Sullivan P, Morgello S, Fischer T. Brain inflammation is a common feature of HIVinfected patients without HIV encephalitis or productive brain infection. Curr HIV Res. 2014;12(2):97-110.

Kamminga J, Cysique LA, Lu G, Batchelor J, Brew BJ. Validity of cognitive screens for HIV-associated neurocognitive disorder: a systematic review and an informed screen selection guide. Curr HIV/AIDS Rep. 2013;10(4):342-55.

Downloads

Published

2016-08-17

How to Cite

Távora, L. G., Figueiredo, T. M., de Mesquita, R. M. K., Bezerra, F. R., Aquino, B. P., & Colares, J. K. de B. (2016). HIV and dementia: prevalence and risk factors. Brazilian Journal in Health Promotion, 29(2), 212–218. https://doi.org/10.5020/18061230.2016.p212

Issue

Section

Original Articles