Depression and diagnosis of neurocognitive impairment in HIV-positive patients

Pinheiro, Cézar Arthur Tavares; Souza, Luciano D.M.; Motta, J V S; Kelbert, Evelin Franco; Souza, Marília Silva de; Martins, Clarissa; Coelho, Fábio Monteiro da Cunha; Pinheiro, Karen Amaral Tavares; Pinheiro, Ricardo Tavares

doi:10.1590/1414-431x20165344

Cited by 43 publications

(50 citation statements)

References 28 publications

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“…The 16 included articles—2 cohort [ 44 , 45 ] and 14 cross-sectional studies [ [46] , [47] , [48] , [49] , [50] , [51] , [52] , [53] , [54] , [55] , [56] , [57] , [58] , [59] ]—were published between 2002 and 2017. Table 1 shows the characteristics of the selected studies.…”

Section: Resultsmentioning

confidence: 99%

Antiretroviral therapy improves neurocognitive impairment in people living with HIV? A meta-analysis

Gao

Meng

Xiao

et al. 2020

International Journal of Nursing Sciences

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Objectives Although effective antiretroviral therapy (ART) has been used for more than two decades, HIV-associated neurocognitive disorder remains prevalent. Thus, whether ART can improve neurocognitive impairment is controversial. This review aims to explore the effects of ART on cognitive impairment in people living with HIV (PLWH). Methods A systematic literature search was conducted in eight databases (PubMed, Embase, Web of Science, Cochrane Library, CNKI, VIP, China Biology Medicine disc, and WanFang) to identify studies that compare cognitive function between study groups who are administered and not administered ART. We searched for articles published up to April 2019. Article evaluation and data extraction were independently conducted by two reviewers. Results Sixteen articles (6,694 participants)—14 cross-sectional studies and 2 cohort studies—were included in this meta-analysis. The cross-sectional studies demonstrated that ART group did not perform better than the non-ART group ( OR = 1.16; 95% CI, 1.03–1.30). However, the cohort studies reported a significant improvement in cognitive function at three months ( OR = 4.01; 95% CI , 2.35–6.85) and six months ( OR = 9.24; 95% CI, 1.71–49.96) after ART initiation compared with the baseline data. No significant cognitive improvement was found in participants younger than 55 years old, but the two cross-sectional studies showed that ART may improve cognitive function in PLWH under 65 years old with poor physical condition and immune status. Conclusions ART could improve cognitive function in PLWH with poor physical condition and immune status, but it does not considerably improve cognition in the entire PLWH population.

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Section: Resultsmentioning

confidence: 99%

Antiretroviral therapy improves neurocognitive impairment in people living with HIV? A meta-analysis

Gao

Meng

Xiao

et al. 2020

International Journal of Nursing Sciences

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“…Depression is a significant problem encountered by people living with HIV because of its association with severe immunodeficiency and disease progression 27 . In this study, depression was associated with poor neurocognitive performance, which supports previous findings in which depression had the greatest association with neurocognitive loss 28 .…”

Section: Discussionmentioning

confidence: 99%

Psycho-behavioral factors associated with neurocognitive performance among people living with HIV on antiretroviral therapy in Accra, Ghana

Asiedu¹,

Kretchy²,

Asampong³

2020

Afr H. Sci.

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Background: It is estimated that almost half of all people living with HIV have some form of neurocognitive impairment, but few studies have looked at the risk of neurocognitive impairment and its associated factors in Ghana, due in part to limited resources for such testing. Objective: To examine neurocognitive performance in a group of Ghanaians living with HIV and possible factors that contribute to their performance. Methods: One hundred and four patients were assessed using a selection of brief non-invasive neuropsychological assess- ments as well as the International HIV Dementia Scale. Psycho-behavioural factors (alcohol use, depression, and medication adherence) as well as demographic characteristics and functional daily activities were assessed to determine their association with neurocognitive performance, using linear regression and receiver operating characteristic analyses. Results: About 48% of the participants met the criteria for risk of neurocognitive impairment. Age, education, and symp- toms of depression were found to be significantly associated with the risk of impairment. Conclusion: Some people living with HIV showed risk of neurocognitive impairment, which was significantly associated with education, age and depressive symptoms. It is therefore important to consider routine neurocognitive screening in HIV management to recognize any risks for early interventions. Keywords: ART adherence; depression; neurologic disease.

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“…In the multivariate model, only depressive symptoms were associated with NCI [ 29 ]. Further, the studies from the CHARTER group (CNS HIV Antiretroviral Effects Research) and other groups have demonstrated an association between mental health conditions and NCI [ 9 , 31 , 49 , 50 ]. However, Cysique affirms that depression and anxiety do not affect NCI [ 30 ].…”

Section: Discussionmentioning

confidence: 99%

The Role of Mental Health Conditions in the Diagnosis of Neurocognitive Impairment in People Living with HIV

et al. 2020

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The aims of the present study were to evaluate the prevalence of undiagnosed mental health conditions (UMHC) in people living with HIV (PLWHIV) on antiretroviral treatment and with long-term suppressed HIV viremia, and its association with neurocognitive impairment (NCI). A cross-sectional observational study on HIV subjects, ≥18 years old, on stable antiretroviral treatment and with HIV viral load <50 copies/mL was carried out. Patients with known comorbidities, substances abuse, anxiety or depression were excluded. UMHC were evaluated by the Millon Clinical Multiaxial Inventory-III and NCI by Frascati criteria. The association between NCI and sociodemographic, clinical HIV variables and mental health conditions was analyzed. Further, the relationship between mental health conditions scores and NCI diagnosis was evaluated. Eighty patients were included, 37.5% had at least one undiagnosed mental health condition, and 26.3% had NCI. The most frequent mental health conditions were: anxiety (21.3%); bipolar disorder (11.3%); and substance dependence (8.8%). Only longer time since HIV diagnosis (p = 0.030) and at least one mental health condition diagnosis (p = 0.002) showed an association with NCI. Participants with NCI presented higher scores in anxiety, alcohol dependence and post-traumatic stress. Undiagnosed mental health conditions are frequent in PLWHIV. These disorders cannot be identified by HIV clinicians or basic screening questionnaires, and they are not usually self-reported by patients. UMHC could act as confounders in the evaluation of NCI.

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Depression and diagnosis of neurocognitive impairment in HIV-positive patients

Cited by 43 publications

References 28 publications

Antiretroviral therapy improves neurocognitive impairment in people living with HIV? A meta-analysis

Antiretroviral therapy improves neurocognitive impairment in people living with HIV? A meta-analysis

Psycho-behavioral factors associated with neurocognitive performance among people living with HIV on antiretroviral therapy in Accra, Ghana

The Role of Mental Health Conditions in the Diagnosis of Neurocognitive Impairment in People Living with HIV

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