Mediterranean Journal of Infection, Microbes and Antimicrobials (Jul 2023)

Prevalence of Asymptomatic HIV-associated Neurocognitive Disorder in a Tertiary Care Hospital in South India: A Single Centered Observational Study

  • Nivedhithaa SELVARAJ,
  • Yoganathan CHIDAMBARAM,
  • C. P. Clement Jenil DHAS,
  • Abilash NEKKANTI,
  • Petchiappan VELAMMAL,
  • Bhargavi KUMAR,
  • Murali ALAGESAN

DOI
https://doi.org/10.4274/mjima.galenos.2022.2023.11
Journal volume & issue
Vol. 12, no. 1

Abstract

Read online

Introduction: Asymptomatic HIV-associated neurocognitive disorder (HAND) is associated with increased morbidity, and it often goes undetected in outpatient clinics due to the lack of awareness and time constraints for a detailed assessment in such cases. We assessed the prevalence of HAND by using Montreal Cognitive Assessment (MoCA) test and evaluated the association between the severity of HIV using CD4 count and cognitive impairment. Materials and Methods: This cross-sectional study enrolled 103 patients (age: 20-80 years) living with HIV who were sampled through convenient sampling technique. Demographic details such as the age, sex, and education, and the current CD4 count were recorded and the patients were accordingly assigned to the following groups: A (>500 cells/µl), B (200-499 cells/µl), and C (<200 cells/µl) with reference to the Center for Disease Control and Prevention guidelines for the distribution of CD4+T cells in HIV. Cognitive impairment in patients was screened using MoCA with a cut-off score of <26. Data was defined using descriptive statistics, between-group comparison was performed using ANOVA and chi-square tests, and the association between the MoCA score and CD4 count was assessed by using Spearman’s correlation coefficient. P<05 was considered to indicate statistical significance. Results: HIV-associated neurocognitive disorder was prevalent among 73.8% of the sample population, where 8.7% had severe, 18.4% had moderate, and 46.6% had mild impairment. Based on the CD4 count, 10.6% were categorized into group A, 39.8% into group B, and 49.5% into group C. The association of the MoCA score with CD4 count was found to be moderately positive and statistically significant (r2=0.644, p=0.000). Conclusion: A high prevalence of HAND, specifically an asymptomatic form, was observed among patients living with HIV. The MoCA score was significantly associated with CD4 count, albeit moderately positive.

Keywords