Neurocognitive function and its influencing factors in people living with HIV/AIDS.
10.11817/j.issn.1672-7347.2024.230555
- Author:
Qiuling LU
1
,
2
,
3
;
Qian YE
1
;
Dan CHEN
4
;
Xingli LI
1
,
5
Author Information
1. Department of Epidemiology and Health Statistics, School of Public Health, Xiangya School of Medicine, Central South University, Changsha
2. luqiulingg@
3. com.
4. Statistics Division, Wuhan Health Information Center, Wuhan 430000, China.
5. lixingli@csu.edu.cn.
- Publication Type:Journal Article
- Keywords:
acquired immune deficiency syndrome;
human immunodeficiency virus;
human immunodeficiency virus associated neurocognitive disorders;
people living with human immunodeficiency virus/acquired immune deficiency syndrome;
the Brief Neurocognitive Screen
- MeSH:
Humans;
Female;
Male;
Middle Aged;
HIV Infections/psychology*;
Adult;
Acquired Immunodeficiency Syndrome/psychology*;
Neuropsychological Tests;
Cognitive Dysfunction/epidemiology*;
Neurocognitive Disorders/epidemiology*;
CD4 Lymphocyte Count;
Risk Factors;
Aged
- From:
Journal of Central South University(Medical Sciences)
2024;49(12):1902-1908
- CountryChina
- Language:English
-
Abstract:
OBJECTIVES:The prevalence of human immunodeficiency virus (HIV) associated neurocognitive disorders (HAND) in people living with HIV/acquired immunodeficiency syndrome (PLWHA) worldwide is as high as 42.6%. This study aims to investigate the neurocognitive function status and its influencing factors in PLWHA, providing evidence for early identification and intervention of neurocognitive impairment in this population.
METHODS:PLWHA aged 18 and above who received outpatient or inpatient care at the First Hospital of Changsha between June and August 2019 were included. Sociodemographic and HIV-related information were collected. Neurocognitive function was assessed using the Brief Neurocognitive Screen (BNCS), which includes the Digit Symbol Test (DST) and Trail Making Test A and B (TMT-A and TMT-B). Impaired neurocognitive function was defined as abnormal scores in at least one dimension (DST score <30, TMT-A time >60 seconds, TMT-B time >90 seconds).
RESULTS:A total of 375 PLWHA were included, of whom 212 (56.5%) exhibited neurocognitive impairment. Higher impairment rates were observed among females, individuals aged ≥50 years, those with primary education or below, and those who were married/cohabiting (all P<0.05). Heterosexual transmission accounted for the majority of infections (233 cases, 62.1%), with a significantly higher rate of neurocognitive impairment (69.1%) compared to homosexual transmission and unknown routes (P<0.001). Higher WHO clinical stages were associated with increased impairment rates (P<0.001). PLWHA with a nadir CD4+ T cell count <200 cells/mm3 or an infection duration ≥5 years had significantly higher impairment rates than those with higher CD4+ T cell count or shorter infection durations (both P<0.05). Logistic regression analysis showed that patients with a nadir CD4+ T cell count <200 cells/mm3 had a significantly higher risk of neurocognitive impairment (OR=2.461, 95% CI 1.116 to 5.427). Compared to WHO stage I, the risk increased progressively in stage II (OR=6.005, 95% CI 2.906 to 12.407), stage III (OR=6.989, 95% CI 2.502 to 19.523), and stage IV (OR=22.059, 95% CI 7.289 to 66.760; all P<0.05).
CONCLUSIONS:Potential risk factors for neurocognitive impairment in PLWHA include low nadir CD4+ T cell counts and advanced WHO clinical stages. The lower the CD4+ T cell count and the higher the clinical stage, the greater the risk of neurocognitive dysfunction.
