title: Screening for Neurocognitive Impairment in HIV-Infected Individuals at First Contact after HIV Diagnosis: The Experience of a Large Clinical Center in Northern Italy.
abstract: Neurocognitive disorders are emerging, probably underestimated, complications in HIV-infected people. The aim of the study was to assess neurocognitive profiles of newly detected HIV-infected patients. We performed an observational retrospective single-cohort study. Illiterates and patients with neurologic symptoms or previous psychiatric diagnosis were excluded. Neuropsychological profiles were assessed using a validated battery of neuropsychological tests. We included 206 patients; with males representing the majority of them (85%). Risk factors for HIV acquisition were unprotected sexual intercourse (homo/bisexual in 39.8% and heterosexual in 60.2%). Thirty-nine patients (18.9%) were previous injection drug users, while 41 (19.9%) were alcohol abusers. Mean education was 11.1 years (SD--standard deviation--3.7). A high prevalence of HIV-associated neurocognitive disorders (HAND, 47.1%) was present in HIV-infected patients: particularly, asymptomatic neurocognitive impairment (ANI) was found in 30.6%, mild neurocognitive disorder (MND) in 15% and HIV-associated dementia (HAD) in 1.5%. Male gender, low degree of education, AIDS diagnosis and gepatitis B virus (HBV) co-infection were factors independently associated with HAND in a multivariable logistic regression model. Our data suggest that patient-specific factors and AIDS diagnosis have a certain kind of impact in HAND occurrence. A complete neuropsychological screening must be recommended in all patients at HIV-infection diagnosis.
authors.affiliation: Department of Infectious and Tropical Diseases, University of Brescia and Brescia Spedali Civili General Hospital, Piazzale Spedali Civili 1, 25123 Brescia, Italy. emanuelefoca@gmail.com.
authors.forename: Emanuele
authors.initials: E
authors.lastname: Focà
authors.affiliation: Department of Infectious and Tropical Diseases, University of Brescia and Brescia Spedali Civili General Hospital, Piazzale Spedali Civili 1, 25123 Brescia, Italy. p.magro@unibs.it.
authors.forename: Paola
authors.initials: P
authors.lastname: Magro
authors.affiliation: Department of Infectious and Tropical Diseases, University of Brescia and Brescia Spedali Civili General Hospital, Piazzale Spedali Civili 1, 25123 Brescia, Italy. davide.motta84@gmail.com.
authors.forename: Davide
authors.initials: D
authors.lastname: Motta
authors.affiliation: Department of Infectious and Tropical Diseases, University of Brescia and Brescia Spedali Civili General Hospital, Piazzale Spedali Civili 1, 25123 Brescia, Italy. compostar@hotmail.com.
authors.forename: Silvia
authors.initials: S
authors.lastname: Compostella
authors.affiliation: Department of Infectious and Tropical Diseases, University of Brescia and Brescia Spedali Civili General Hospital, Piazzale Spedali Civili 1, 25123 Brescia, Italy. s.casari@infettivibrescia.it.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Casari
authors.affiliation: Department of Infectious and Tropical Diseases, University of Brescia and Brescia Spedali Civili General Hospital, Piazzale Spedali Civili 1, 25123 Brescia, Italy. andreabonito@hotmail.com.
authors.forename: Andrea
authors.initials: A
authors.lastname: Bonito
authors.affiliation: Department of Infectious and Tropical Diseases, University of Brescia and Brescia Spedali Civili General Hospital, Piazzale Spedali Civili 1, 25123 Brescia, Italy. nigri_bri@libero.it.
authors.forename: Nigritella
authors.initials: N
authors.lastname: Brianese
authors.affiliation: Department of Infectious and Tropical Diseases, University of Brescia and Brescia Spedali Civili General Hospital, Piazzale Spedali Civili 1, 25123 Brescia, Italy. alice-ferraresi@hotmail.it.
authors.forename: Alice
authors.initials: A
authors.lastname: Ferraresi
authors.affiliation: Department of Infectious and Tropical Diseases, University of Brescia and Brescia Spedali Civili General Hospital, Piazzale Spedali Civili 1, 25123 Brescia, Italy. paolarodari@icluod.com.
authors.forename: Paola
authors.initials: P
authors.lastname: Rodari
authors.affiliation: Department of Infectious and Tropical Diseases, University of Brescia and Brescia Spedali Civili General Hospital, Piazzale Spedali Civili 1, 25123 Brescia, Italy. chiarapezzoli@yahoo.com.
authors.forename: Maria Chiara
authors.initials: MC
authors.lastname: Pezzoli
authors.affiliation: Department of Infectious and Tropical Diseases, University of Brescia and Brescia Spedali Civili General Hospital, Piazzale Spedali Civili 1, 25123 Brescia, Italy. eugeniaquiros@yahoo.it.
authors.forename: Eugenia
authors.initials: E
authors.lastname: Quiros-Roldan
authors.affiliation: Department of Infectious and Tropical Diseases, University of Brescia and Brescia Spedali Civili General Hospital, Piazzale Spedali Civili 1, 25123 Brescia, Italy. francesco.castelli@unibs.it.
authors.forename: Francesco
authors.initials: F
authors.lastname: Castelli
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000150:complications; D015331:Cohort Studies; D060085:Coinfection / Q000150:complications / Q000175:diagnosis; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000175:diagnosis*; D006509:Hepatitis B / Q000150:complications / Q000175:diagnosis; D006801:Humans; D007558:Italy; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D019965:Neurocognitive Disorders / Q000453:epidemiology / Q000209:etiology*; D009483:Neuropsychological Tests; D015995:Prevalence; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D019966:Substance-Related Disorders / Q000150:complications
keywords: HIV; HIV-associated dementia; neurocognitive disorders