Quality of life in people living with HIV-associated neurocognitive disorder: A scoping review study

Abstract

Quality of life (QoL) is recognized as an essential end point in the disease management of chronic conditions such as HIV with calls to include good QoL as a ‘fourth 90’ in the 90-90-90 testing and treatment targets introduced by World Health Organization in 2016. Cognitive impairments impact a broad spectrum of experiences and are a common issue effecting people living with HIV (PLWH). Despite this, few studies have examined QoL in PLWH who also have a cognitive disorder. This study aimed to synthesize and describe what is known about QoL in those living with HIV-associated neurocognitive disorders (HAND). A scoping review of peer-reviewed literature was conducted to identify how QoL has been investigated and measured in PLWH with HAND, and how PLWH with HAND report and describe their QoL. We searched PsychInfo, Medline, Scopus, and Web of Science along with hand-searching reference lists from relevant studies found. Included studies were those published in English after 1st January 2003 which included PLWH with cognitive impairment not due to other pre-existing conditions. Fifteen articles met criteria for inclusion. Two studies measured QoL as a primary aim, with others including QoL assessment as part of a broader battery of outcomes. The MOS-HIV and SF-36 were the most commonly used measures of overall QoL, with findings generally suggestive of poorer overall QoL in PLWH with HAND, compared to PLWH without cognitive impairment. Studies which examined dimensions of QoL focused exclusively on functionality, level of independence, and psychological QoL domains. There is a considerable dearth of research examining QoL in PLWH with HAND. The initiatives which advocate for healthy aging and improved QoL in PLWH must be extended to include and understand the experiences those also living with cognitive impairment. Research is needed to understand the broad experiential impacts of living with these two complex, chronic conditions, to ensure interventions are meaningful to patients and potential benefits are not missed.

Cognitive Functioning and Its Relationship with Self-Stigma in Men with HIV Who Have Sex with Men: The Mediating Role of Health-Related Quality of Life

“…This relationship has previously been described in the literature, 49–51 but our study has further contributed to the field, thus addressing suggestions of future research in this line. 48 As such, our article supports the relevance of evaluating the quality of life and interacting factors for PLWHIV. Our work also supports HIV advocacy groups that are calling for its inclusion as an additional 90 in the 90-90-90 testing and treatment target introduced by the World Health Organization in 2016.…”

“…The latter is recognised as a subjective and multidimensional well-being variable that involves an individual’s physical, mental, emotional, and social functioning, and is essential for the management of chronic diseases such as HIV. 48 , 49 According to a recent review, few studies have hitherto analysed the relationship between HRQoL and neurocognitive impairment in MSM with HIV. 48 Nevertheless, some previous studies have found that the presence of neurocognitive impairment is significantly associated with lower HRQoL scores in HIV-positive MSM.…”

“… 48 , 49 According to a recent review, few studies have hitherto analysed the relationship between HRQoL and neurocognitive impairment in MSM with HIV. 48 Nevertheless, some previous studies have found that the presence of neurocognitive impairment is significantly associated with lower HRQoL scores in HIV-positive MSM. 49–51 As a result, HRQoL has become an important health outcome for people living with HIV.…”

“A fog that impacts everything”: a qualitative study of health-related quality of life in people living with HIV who have cognitive impairment

“…Interviews lasted 45–97 min and were audio-recorded, transcribed verbatim and checked for accuracy. Interview guides based on a review of the HRQoL literature and experiences of PLWH with CI [ 29 ] were used to structure the interview. Questions were open-ended, and probing.…”

Methamphetamine induces transcriptional changes in cultured HIV-infected mature monocytes that may contribute to HIV neuropathogenesis

“…HIV-NCI is a spectrum of disorders that can fluctuate over time and includes, but is not limited to, impaired executive function, working memory, and attention ( 2 ). People with HIV-NCI have a premature decline in overall physical and psychological health, with difficulties maintaining employment and social relationships and in performing instrumental activities of daily living ( 9 – 13 ). HIV-NCI is an independent risk factor for mortality, and currently, there are no effective treatments in the context of ART ( 14 – 16 ).…”