title: Neurocognitive symptoms and impairment in an HIV community clinic.
abstract: BACKGROUND
  Neurocognitive impairment is a frequent complication of HIV infection and heralds a poor survival prognosis. With the availability of highly active antiretroviral therapy (HAART), survival times for HIV-infected patients have markedly increased although the effects of HAART on the prevalence of neurocognitive impairment remain uncertain.
  
  
  OBJECTIVE
  To determine the relationship between self-reported neurocognitive symptoms and neuropsychological (NP) performance together with the impact of HAART among HIV-infected patients.
  
  
  METHODS
  A cross-sectional study was performed in which patients without previously documented neurocognitive impairment attending an HIV community clinic were questioned about neurocognitive symptoms and a NP test battery was administered.
  
  
  RESULTS
  Of the eighty-three patients examined, neurocognitive symptoms were reported by 34% of patients and were associated with a shorter duration of HAART and higher viral loads. Patients reporting neurocognitive symptoms were also more likely to exhibit impaired NP performance (p<0.005) with NP impairment being detected in 46% of all patients examined (12% with HIV-associated dementia). Neuropsychological impairment was directly correlated with age (p<0.001), plasma viral load (p<0.005) and inversely correlated with the number of prescribed antiretroviral drugs (p<0.01).
  
  
  CONCLUSIONS
  These results suggest that neurocognitive symptoms are predictive of impaired NP performance and that NP impairment remains a frequent finding among older patients with higher viral loads. An increased number of antiretroviral drugs may be neuroprotective.
authors.affiliation: Department of Clinical Neurosciences, University of Calgary, AB, Canada.
authors.forename: D H
authors.initials: DH
authors.lastname: Kim
authors.forename: D L
authors.initials: DL
authors.lastname: Jewison
authors.forename: G R
authors.initials: GR
authors.lastname: Milner
authors.forename: S B
authors.initials: SB
authors.lastname: Rourke
authors.forename: M J
authors.initials: MJ
authors.lastname: Gill
authors.forename: C
authors.initials: C
authors.lastname: Power
mesh_terms: D000328:Adult; D000368:Aged; D003072:Cognition Disorders / Q000209:etiology* / Q000523:psychology*; D003153:Community Health Services; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests