当前位置： SCI文献检索 > BMC INFECTIOUS DISEASES期刊下所有文献 > Cognitive screening in treatment-naïve HIV-infected individuals in Hong Kong - a single center study.

Cognitive screening in treatment-naïve HIV-infected individuals in Hong Kong - a single center study.

Abstract：

BACKGROUND:HIV-associated neurocognitive disorder (HAND) remains prevalent in the era of combination antiretroviral therapy (cART). The prevalence of HAND in Hong Kong is not known. METHODS:Between 2013 and 2015, 98 treatment-naïve HIV-1-infected individuals were referred to and screened by the AIDS Clinical Service, Queen Elizabeth Hospital with (1) the International HIV Dementia Scale (IHDS), a screening tool that targets moderate to severe HAND, (2) the Montreal Cognitive Assessment (MoCA), a frequently used cognitive screening test and (3) the Patient Health Questionnare-9 (PHQ-9), a 9-item questionnaire that evaluates depression symptoms. Within the study period, 57 of them completed the second set of IHDS and MoCA at 6 months after baseline assessment. RESULTS:Most participants were male (94%), with a median age of 31 years. At baseline, 38 (39%) and 25 (26%) of them scored below the IHDS (≤10) and MoCA (25/26) cut-offs respectively. Poor IHDS performers also scored lower on MoCA (p = 0.039) but the correlation between IHDS and MoCA performance was weak (r = 0.29, p = 0.004). Up to a third of poor IHDS performers (13/38) showed moderate depression (PHQ-9 > 9). In the multivariable analysis, a lower education level (p = 0.088), a history of prior psychiatric illness (p = 0.091) and the presence of moderate depression (p = 0.079) tended to be significantly associated with poor IHDS performance. At follow-up, 54 out of 57 were on cART, of which 46 (85%) had achieved viral suppression. Their blood CD4+ T-lymphocytes and IHDS scores were higher at follow-up compared to baseline values (both p < 0.001) but their MoCA performance was similar at both assessments. Of note, 17 participants in this subgroup scored below the IHDS cut-off at both assessments. CONCLUSIONS:Poor IHDS performance, and likely cognitive impairment, was frequently observed in treatment-naïve HIV-infected individuals in our locality. A considerable proportion continued to score below the IHDS cut-off at 6 months after cART. Depression was frequently observed in this vulnerable population and was associated with poor IHDS performance.

journal_name

BMC Infect Dis

journal_title

BMC infectious diseases

authors

Chan FCC,Chan P,Chan I,Chan A,Tang THC,Lam W,Fong WC,Lee MP,Li P,Chan GHF

doi

10.1186/s12879-019-3784-y

subject

Has Abstract

pub_date

2019-02-13 00:00:00

pages

156

issue

issn

1471-2334

pii

10.1186/s12879-019-3784-y

journal_volume

pub_type

杂志文章

在线工具

Cognitive screening in treatment-naïve HIV-infected individuals in Hong Kong - a single center study.