Abstract Details

Title A High Prevalence Rate of a Positive Screen for Cognitive Impairment in Patients with HIV Attending an Irish Clinic

Topic Infections/AIDS/Prion Disease

Presentation(s) P06 - (-)

Poster/Presentation
Number 190

Objective

Background BACKGROUND: The incidence of HIV-associated dementia decreased after the introduction of highly active antiretroviral therapy but various studies have demonstrated prevalence rates of 20% to 50% of cognitive impairment.

Design/Methods DESIGN/METHODS: This was a cross-sectional, prospective study. Patients were recruited from HIV outpatient clinics. Cognitive screening was performed using the Brief NeuroCognitive Screen. Primary endpoints were the rate of a positive screen for cognitive impairment and the identification of risk factors for a positive screen. Statistical analysis was carried out using SPSS version 18.

Results RESULTS: 600 patients have participated. 80% were male. 50% had a positive screen for cognitive impairment. On univariate analysis the following factors were statistically significantly associated with the presence of a positive screen for cognitive impairment: endorsement of cognitive symptoms (p=0.024), female gender (p<0.001), a non-Irish country of birth particularly Africa (p<0.001), English as a second language (p<0.001), younger age (p=0.032), heterosexual mode of transmission (p<0.001), use of methadone (p=0.004), being unemployed (p<0.001), a positive screen for anxiety (p=0.017) and depression (p=0.032) and a lower nadir CD4 count (p=0.042).

Conclusions CONCLUSIONS: We identified a prevalence rate of 50% of a positive screen for cognitive impairment. Some of the statistically significant associations such as younger age, heterosexual mode of transmission and female gender may be influenced by the African patients in the study for whom there is a paucity of normative data. We identified potential risk factors for the development of cognitive impairment. We recommend annual screening for cognitive impairment in all HIV positive patients and referral onto specialist services for those with a positive screen for further assessment.

Authors/Disclosures
Patricia McNamara, MD, PhD (National Hospital for Neurology and Neurosurgery) PRESENTER	No disclosure on file
	No disclosure on file
Dusan Stefoski, MD, FAAN	No disclosure on file
	No disclosure on file
Janice M. Redmond, MD	Dr. Redmond has nothing to disclose.
Colin Doherty, MD	The institution of Dr. Doherty has received research support from UCB pharma. The institution of Dr. Doherty has received research support from Science foundation Ireland.

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