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Neurocognitive course at 2-year follow-up in a Swiss cohort of people with well-treated HIV
- Source :
- AIDS, vol. 35, no. 15, pp. 2469-2480, AIDS (London, England)
- Publication Year :
- 2021
-
Abstract
- Objective: The aim of this study was to examine neurocognitive course over time among people with well treated HIV. Design: The Neurocognitive Assessment in the Metabolic and Aging Cohort (NAMACO) study is an ongoing, prospective, longitudinal, multicenter and multilingual study within the Swiss HIV Cohort Study (SHCS). Participants undergo neuropsychological assessment at baseline and two-yearly follow-up. Setting: Seven SHCS centres. Participants: Patients aged at least 45 years enrolled in the SHCS with fluency in the local language (French, German or Italian) and agreeing to participate in the NAMACO study: 981 participants at baseline, 720 at 2-year follow-up of whom 644 had complete data sets. Intervention: Standardized neuropsychological assessment at baseline and 2-year follow-up. Main outcome measure: Neurocognitive performance using Frascati criteria and mean z-scores. Results: Four participants (of 644, 0.6%) had plasma HIV-1 RNA more than 50 copies/ml; median CD4+ cell count was 660 cells/μl. According to Frascati criteria, 204 participants (31.7%) had neurocognitive impairment (NCI) at baseline. NCI severity in these participants changed little over 2 years and comprehensive models based on Frascati criteria were not feasible. Examining mean z-scores, however, we observed neurocognitive stability or improvement over two years in five of seven neurocognitive domains assessed. Age at least 65 years (P = 0.02) and cognitive complaints (P = 0.004) were associated with neurocognitive decline, while black race (P = 0.01) and dolutegravir treatment (P = 0.002) were associated with improvement. Conclusion: Frascati criteria were less sensitive in measuring NCI change and therefore unsuitable for following neurocognitive course in our cohort of people with well treated HIV. Examining neurocognitive course by mean z-score change, we observed stability or improvement.
- Subjects :
- Pediatrics
medicine.medical_specialty
Complete data
Immunology
HIV Infections
Neuropsychological Tests
Black race
Cohort Studies
Follow-Up Studies
HIV Infections/complications
HIV Infections/drug therapy
Humans
Prospective Studies
Switzerland/epidemiology
chemistry.chemical_compound
medicine
neurocognitive impairment
Immunology and Allergy
Neuropsychological assessment
medicine.diagnostic_test
HIV-associated neurocognitive disorder
business.industry
aging
HIV
Cognition
Clinical Science
neuropsychological testing
Infectious Diseases
chemistry
Dolutegravir
Cohort
business
Neurocognitive
Switzerland
Cohort study
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Journal :
- AIDS, vol. 35, no. 15, pp. 2469-2480, AIDS (London, England)
- Accession number :
- edsair.doi.dedup.....e052aaece603e6c33419f09ca704f751