Abstract
It is estimated that almost half of all people living with HIV have some form of neurocognitive impairment, but few studies have looked at the risk of neurocognitive impairment and its associated factors in Ghana, due in part to limited resources for such testing. To examine neurocognitive performance in a group of Ghanaians living with HIV and possible factors that contribute to their performance. One hundred and four patients were assessed using a selection of brief non-invasive neuropsychological assessments as well as the International HIV Dementia Scale. Psycho-behavioural factors (alcohol use, depression, and medication adherence) as well as demographic characteristics and functional daily activities were assessed to determine their association with neurocognitive performance, using linear regression and receiver operating characteristic analyses. About 48% of the participants met the criteria for risk of neurocognitive impairment. Age, education, and symptoms of depression were found to be significantly associated with the risk of impairment. Some people living with HIV showed risk of neurocognitive impairment, which was significantly associated with education, age and depressive symptoms. It is therefore important to consider routine neurocognitive screening in HIV management to recognize any risks for early interventions.
Highlights
The Human Immunodeficiency Virus (HIV) compromises the immune system to cause Acquired Immune Deficiency Syndrome (AIDS) and has the capability to infect the central nervous system (CNS)[1]
A major consequence of HIV infection in the brain, especially for patients without medication, is neurocognitive impairment (NCI) or what are sometimes categorized as HIV Associated Neurocognitive Disorders (HAND)[2,3]
It has been debated whether International HIV Dementia Scale (IHDS) can be effective for diagnosing the milder categories of HAND, with some researchers advocating that the IHDS should be combined with other neurocognitive tests, such as TMT to make it more sensitive to milder NCI23
Summary
The Human Immunodeficiency Virus (HIV) compromises the immune system to cause Acquired Immune Deficiency Syndrome (AIDS) and has the capability to infect the central nervous system (CNS)[1]. A major consequence of HIV infection in the brain, especially for patients without medication, is neurocognitive impairment (NCI) or what are sometimes categorized as HIV Associated Neurocognitive Disorders (HAND)[2,3]. Psycho-behavioural factors (alcohol use, depression, and medication adherence) as well as demographic characteristics and functional daily activities were assessed to determine their association with neurocognitive performance, using linear regression and receiver operating characteristic analyses. Education, and symptoms of depression were found to be significantly associated with the risk of impairment. Conclusion: Some people living with HIV showed risk of neurocognitive impairment, which was significantly associated with education, age and depressive symptoms. Psycho-behavioral factors associated with neurocognitive performance among people living with HIV on antiretroviral therapy in Accra, Ghana. All participants had a mean score of 6 on the instrumental activities of daily living, indicating optimal independent physical functioning
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