title: High prevalence of HIV-associated neurocognitive disorder in HIV-infected patients with a baseline CD4 count ≤ 350 cells/μL in Shanghai, China.
abstract: This study sought to determine the prevalence and risk factors of HIV-associated neurocognitive disorder (HAND) in HIV-infected patients with a baseline CD4 count ≤ 350 cells/μL in Shanghai, China. Subjects were 309 HIV-infected patients with a baseline CD4 count ≤ 350 cells/μL. General demographic and clinical information were collected by patient interview. Patients' cognitive function was assessed using the Montreal Cognitive Assessment (MoCA), combined with a questionnaire on cognitive complaints. The median age of patients was 34 years (IQR: 28-43.5). In terms of sex, 272 (88.0%) of the patients were male. Of the patients, 236 (76.4%) had been on antiretroviral treatment (ART) (for a median duration of 14 months, IQR: 1-29 months) before the study. Of the patients, 183 (59.2%) mentioned having a cognitive disorder. MoCA screening revealed that the prevalence of HAND was 48.2% and that HAND was more prevalent in patients with cognitive complaints (53.0%) than in patients with no such complaints (41.3%) (p = 0.042). Multivariate analysis indicated that HAND was associated with being female (p = 0.006), being older (p < 0.001), having a lower level of education (p < 0.001), and longer use of efavirenz in an ART regimen (p = 0.040). This study found that HAND frequently developed in HIV-infected patients with a baseline CD4 count ≤ 350 cells/μL in Shanghai, China. Being older, being female, having a low level of education, and receiving efavirenz treatment for a longer period may be associated with a greater risk of developing HAND. This study suggests that HAND should be routinely screened for in all newly diagnosed HIV-positive patients, and especially in those with the aforementioned risk factors for developing HAND.
authors.affiliation: Department of Infectious Diseases, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China.
authors.forename: Zhenyan
authors.initials: Z
authors.lastname: Wang
authors.forename: Yufang
authors.initials: Y
authors.lastname: Zheng
authors.forename: Li
authors.initials: L
authors.lastname: Liu
authors.forename: Yinzhong
authors.initials: Y
authors.lastname: Shen
authors.forename: Renfang
authors.initials: R
authors.lastname: Zhang
authors.forename: Jiangrong
authors.initials: J
authors.lastname: Wang
authors.forename: Hongzhou
authors.initials: H
authors.lastname: Lu
mesh_terms: D000328:Adult; D018791:CD4 Lymphocyte Count; D002681:China; D003072:Cognition Disorders / Q000453:epidemiology* / Q000209:etiology* / Q000378:metabolism; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000453:epidemiology* / Q000378:metabolism; D006801:Humans; D008297:Male; D015995:Prevalence; D012307:Risk Factors