September 1-November 30, 2020
Background and Purpose - The human immunodeficiency virus (HIV) is associated with a myriad of AIDS defining illnesses, including neurocognitive decline. The neurological complications associated with HIV include cognitive, behavioral, and motor disturbances. The prevalence of HIV associated neurocognitive disorders among Filipinos has not been well established. This study aims to determine its prevalence and to determine its association with the duration of disease and treatment, CD4 counts and viral load.
Methods - This is an observational cross-sectional study conducted among patients with HIV/AIDS seen at Baguio General Hospital and Medical Center from September to November 2020. Patients ≥19 years old diagnosed with HIV/AIDS were included. Patients with known history of non-HIV related neurocognitive disorders, CNS infections, major psychiatric disorders, and current alcohol or substance dependence were excluded. Seventy-four participants were included in the study. The Self-Perception Questionnaire, Mini Mental Status Examination, Montreal Cognitive Assessment Test and International HIV Dementia Scale were administered to all participants. Descriptive and inferential statistics were used to determine the prevalence of neurocognitive impairments and their association with the factors of interest.
Results - Results of this study showed that 55.4% participants reported symptoms of neurocognitive impairments in the SPQ. Among these participants with self-reported neurocognitive impairments, none had abnormal results using the MMSE, only 4 had abnormal IHDS scores and 7 had abnormal MOCA scores. This study also noted that 8.1% and 13.51% of the participants scored below the cut-off scores for normal in the IHDS and MOCA respectively. Among these participants with objective findings of neurocognitive impairments, 6% had no subjective complaints but were found to have impairments in the IHDS. When tested with the MOCA, 9% of the participants with no self-perceived cognitive impairments yielded abnormal results. The occurrence of neurocognitive impairments was found to be significantly associated with duration of the disease (p=0.021) but was not significantly associated with age, educational attainment, duration of ART, CD4 counts and viral load.
Conclusions - Identifying the subset of patients with HIV/AIDS who have neurocognitive impairments, especially in the asymptomatic stage, is recommended to detect early functional impairments and potentially prevent transition to more severe stages which can affect quality of life.
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