Neuropsychological Assessment of 412 HIV-Infected Individuals in Saõ Paulo, Brazil

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dc.contributor.authorGascon M.R.P.
dc.contributor.authorVidal J.E.
dc.contributor.authorMazzaro Y.M.
dc.contributor.authorSmid J.
dc.contributor.authorMarcusso R.M.N.
dc.contributor.authorCapitao C.G.
dc.contributor.authorCoutinho E.M.
dc.contributor.authorBenute G.R.G.
dc.contributor.authorDe Lucia M.C.S.
dc.contributor.authorDe Oliveira A.C.P.
dc.date.accessioned2024-03-12T23:59:56Z
dc.date.available2024-03-12T23:59:56Z
dc.date.issued2018
dc.description.abstract© 2018, Mary Ann Liebert, Inc.HIV-Associated neurocognitive disorders (HAND) remain frequent even among individuals receiving combined antiretroviral therapy (cART). In addition, HAND may adversely affect the quality of life and adherence to cART. There is scarce epidemiological information about HAND in Latin America. This cross-sectional study recruited HIV-infected patients from a tertiary teaching institution in Saõ Paulo, Brazil, between May 2013 and February 2015. The patients were adults with at least 4 years of education and patients with current neurological or psychiatric diseases were excluded. HAND remain frequent even among individuals receiving cART, use of psychoactive substance, or inability to understand the content for neuropsychological evaluation. We used standardized tools to evaluate depression, use of psychoactive substances, and daily life activities, and we performed a comprehensive neuropsychological examination. HAND was classified using the Frascati criteria. Prevalence of HAND was estimated, and an associated variable of symptomatic HAND was identified by logistic regression. Four-hundred twelve HIV-infected patients were included [male: 281 (68%), mean age of 45.3 years]. Most of them [n = 340 (83.7%)] had an undetectable viral load. The prevalence of HAND was 73.6% (n = 303): 210 (50.9%) had asymptomatic neurocognitive involvement (ANI), 67 (16.2%) had mild neurocognitive disorder (MND), and 26 (6.3%) had HIV-associated dementia (HAD). The univariate logistic regression analysis showed that female gender, age older than 50 years, <11 years of schooling, CD4 count below 200 cells/mm3, presence of previous illnesses (e.g., diabetes, hypertension), opportunistic disease history, and a Beck Depression Inventory (BDI) score between 13 and 19 points were factors associated with symptomatic HAND (MND and HAD). However, a BDI score between 13 and 19 points was the single independent variable associated with symptomatic HAND. HAND was highly prevalent in Saõ Paulo, Brazil, and ANI was the more frequent category of HAND. However, 22.5% of participants had symptomatic HAND. This finding constitutes a challenge in clinical practice. A BDI score between 13 and 19 points was the single independent variable associated with symptomatic HAND.
dc.description.firstpage1
dc.description.issuenumber1
dc.description.lastpage8
dc.description.volume32
dc.identifier.doi10.1089/apc.2017.0202
dc.identifier.issn1557-7449
dc.identifier.urihttps://dspace.mackenzie.br/handle/10899/35647
dc.relation.ispartofAIDS Patient Care and STDs
dc.rightsAcesso Restrito
dc.subject.otherlanguageacquired immunodeficiency syndrome
dc.subject.otherlanguageAIDS dementia complex
dc.subject.otherlanguagecentral nervous system
dc.subject.otherlanguageHIV
dc.subject.otherlanguageneurocognitive disorders
dc.titleNeuropsychological Assessment of 412 HIV-Infected Individuals in Saõ Paulo, Brazil
dc.typeArtigo
local.scopus.citations27
local.scopus.eid2-s2.0-85040558857
local.scopus.subjectActivities of Daily Living
local.scopus.subjectAdult
local.scopus.subjectAged
local.scopus.subjectAIDS Dementia Complex
local.scopus.subjectAnti-Retroviral Agents
local.scopus.subjectBrazil
local.scopus.subjectCD4 Lymphocyte Count
local.scopus.subjectCognition Disorders
local.scopus.subjectCognitive Dysfunction
local.scopus.subjectCross-Sectional Studies
local.scopus.subjectDepression
local.scopus.subjectEducational Status
local.scopus.subjectFemale
local.scopus.subjectHIV Infections
local.scopus.subjectHumans
local.scopus.subjectMale
local.scopus.subjectMiddle Aged
local.scopus.subjectNeuropsychological Tests
local.scopus.subjectPrevalence
local.scopus.subjectPsychiatric Status Rating Scales
local.scopus.subjectQuality of Life
local.scopus.subjectViral Load
local.scopus.updated2024-05-01
local.scopus.urlhttps://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85040558857&origin=inward
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