Prevalence and risk factors for human immunodeficiency virus-associated neurocognitive impairment, 1996 to 2002: results from an urban observational cohort.
To assess prevalence and risk factors for human immunodeficiency virus (HIV)-related neurocognitive impairment (NCI), the authors performed a 7-year survey in the period 1996 to 2002. A total of 432 patients were examined. HIV-related NCI was diagnosed in 238 patients (55.1%), meeting the HIV dementia (HIV-D) criteria in 45 (10.4%). The prevalence of both NCI and HIV-D did not change significantly during the study period. Compared with patients without NCI, patients with NCI were older (40.4 versus 38.2 years; P = .003), had a higher prevalence of positive HCV serology (61.1% versus 38.9%; P = .003), and a lower nadir CD4 cell count (156 versus 222 cells/microl; P < .001). Compared with patients seen during 1996 to 1999, patients with NCI seen during 2000 to 2002 were older (40.7 versus 38.8 years; P = .004), had a less advanced disease stage (previous acquired immunodeficiency syndrome [AIDS] 28.8% versus 65.7%; P < .001) and a higher nadir CD4 count (174 versus 132 cells/microl; P = .026). This study showed an unchanged prevalence of both HIV-related NCI and HIV-D in the period 1996 to 2002. The authors found evidences for new additional potential risk factors for HIV-related NCI (older age, lower nadir CD4 count, positive hepatitis C virus [HCV] serology), and for a change of risk factors for NCI in the late highly active antiretroviral therapy (HAART) era (older age, less advanced disease, higher nadir CD4 count).
Tozzi
Valerio
V
National Institute for Infectious Diseases Lazzaro Spallanzani, Rome, Italy. tozzi@inmi.it
Balestra
Pietro
P
Lorenzini
Patrizia
P
Bellagamba
Rita
R
Galgani
Simonetta
S
Corpolongo
Angela
A
Vlassi
Chrysoula
C
Larussa
Dora
D
Zaccarelli
Mauro
M
Noto
Pasquale
P
Visco-Comandini
Ubaldo
U
Giulianelli
Marinella
M
Ippolito
Giuseppe
G
Antinori
Andrea
A
Narciso
Pasquale
P
D015526:AIDS Dementia Complex / Q000453:epidemiology* / Q000276:immunology / Q000473:pathology; D000328:Adult; D000367:Age Factors; D018791:CD4 Lymphocyte Count; D003072:Cognition Disorders / Q000453:epidemiology* / Q000276:immunology / Q000473:pathology; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D006306:Health Surveys; D006526:Hepatitis C / Q000453:epidemiology; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D009422:Nervous System Diseases; D015995:Prevalence; D012307:Risk Factors