Study to assess the prevalence, nature and extent of cognitive impairment in people living with AIDS

Abstract

Background:HIV directly affects the brain and produces varied psychiatric manifestations. 10-30% of patients with AIDS were found to have cognitive impairment and the virus is isolated in the CSF in 70% of AIDS patients.Aim:The present study is aimed at finding out the prevalence, nature, and extent of cognitive changes in AIDS patients.Materials and Methods:The consecutive sample of 33 patients with AIDS attending the ART center of our college were clinically interviewed and administered MMSE, BGT, Wechsler Memory Scale, and International HIV Dementia Scale.Results:In clinical assessment, only 1/33 (3%) patients could be diagnosed as dementia in HIV disease (ICD10-F02.4). This confirms the current Indian reports which indicate a lower prevalence of HIV dementia in our population. 2/33 (6%) patients were recognized to have mild cognitive disorder due to HIV disease (ICD10-F06.7). Asymptomatic cognitive impairment is very common in AIDS patients and it was noted in 69% of our study population. In the tests, MMSE was positive in only 3 of the 33 patients (9%) and it was not helpful to recognize cognitive deficits in our patients. The Wechsler Memory Scale was abnormal in 18 of the 33 patients (55%). BGT was abnormal in 48.5% of patients. The International HIV Dementia Scale was the most sensitive instrument and 63.6% the patients had abnormal scores in this scale.Conclusion:Tests which assess cognitive and motor speed may be more helpful than clinical psychiatric interview to spot the AIDS patients who have cognitive impairment.