Cognitive Impairment Becoming More Common in Patients with HIV

Prevalence of cognitive impairment (CI) has increased among the HIV population while services for diagnosing and treating afflicted individuals remains scarce,

according to a new study

, which explored the development and management of neurological disorders in 52 patients living with HIV (PLWH).

A UK-based clinic performed a memory assessment service and found that 79% of patients had impartial CI: 31% met conditions for HIV-associated neurocognitive disorder (HAND), 4% were diagnosed with dementia, 27% showed CI related to mental illness or substance abuse, 13% had CI believed to be caused by factors other than HIV, and 4% had CI due to unknown reasons. The researchers found 62% of patients displayed at least partial abnormality on magnetic resonance imaging brain scans and that all patients scored significantly below average on tests of global cognition and executive functioning. The authors advocated that specialist HIV memory services should be included in future patient care.

HAND serves as an umbrella term to cover a wide spectrum of neurological disorders, including asymptomatic neurocognitive impairment, mild neurocognitive disorder, and HIV-associated dementia. The prevalence of HAND has been frequently determined by the Frascati criteria, a neurocognitive rating scale developed in 2007 that involves neuropsychological testing across multiple cognitive domains. However, the Frascati criteria has been criticized to lack specificity and sensitivity, resulting in an uncommon amount of false-positive diagnoses.

“Based on Frascati criteria, 81% of patients attending the clinic would be diagnosed with HAND,” the authors explained. “Using our diagnostic processes, we found 79% had objective CI, however of these, 61% had a reason for this that was not HIV-related and only 39% had ‘true’ HAND.

Continue reading on The American Journal of Managed Care.