Abstract
Presence of the hepatitis C virus in HIV infected patients has an additional neurotoxic influence on the Central Nervous System. It has been described that HCV co-infection leads to neuropsychological impairment whose severity is greater than in mono-HIV infected subjects. In the present study we assessed the neuropsychological status of 46 human immunodeficiency virus (HIV)-infected individuals from the Warsaw Hospital for Infectious Diseases. For the purpose of cognitive assessment, neuropsychological tests measuring global cognitive functions, attention and perception, verbal memory, as well as non-verbal aspects of executive functions, e.g. visual monitoring and planning, were assessed. In 60% of the investigated patients, who were co-infected with the hepatitis C virus, the overall cognitive outcome observed was worse than in mono-HIV infected subjects. The following factors were taken into account: ART therapy’s influence on cognitive functions using the CPE rank (CNS Penetration Efficacy, 2010), route of HIV transmission, conditions of human existence and age of investigated patients. The present work should be treated as a preliminary research and interpreted in the context of several limitations described in the text.
Highlights
In the era of antiretroviral treatment (ART), it is not protection from death but from life with serious neurocognitive disorders that poses a challenge in the treatment of patients with a human immunodeficiency virus (HIV) infection
The criteria of HAND, as defined by the American Academy of Neurology in 1991, were revised in 2007 [5]. They are divided into three categories: 1) asymptomatic neurocognitive impairment (ANI), i.e. a mild cognitive dysfunction detected in neuropsychological tests; 2) mild neurocognitive disorders (MND); 3) HIV-associated dementia (HAD) that may be observed even in young individuals, a serious neurocognitive disorder that leads to significant difficulties in everyday functioning
Our aim was to assess the cognitive status of 46 subjects (38 males, 8 females), who were undergoing antiretroviral treatment (ART), and to find statistically significant in-group differences taking into account the patients’ current medical status, HCV co-infection, ART therapy’s influence on cognitive functions using the CPE rank (CNS Penetration Efficacy, 2010), routes of HIV transmission, conditions of human existence, as well as selected demographic and psychosocial data
Summary
In the era of antiretroviral treatment (ART), it is not protection from death but from life with serious neurocognitive disorders that poses a challenge in the treatment of patients with a human immunodeficiency virus (HIV) infection. Cognitive deficits cause problems in everyday life that result in impairment in the ability to assess new information, as well as planning and monitoring behavior. This has a great impact on the patient’s quality of life. The criteria of HAND, as defined by the American Academy of Neurology in 1991, were revised in 2007 [5] At present, they are divided into three categories: 1) asymptomatic neurocognitive impairment (ANI), i.e. a mild cognitive dysfunction detected in neuropsychological tests; 2) mild neurocognitive disorders (MND); 3) HIV-associated dementia (HAD) that may be observed even in young individuals, a serious neurocognitive disorder that leads to significant difficulties in everyday functioning. Cognitive functioning tends to be WJA more impaired in patients with poor medication adherence [8]
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