To evaluate the relationship between mental health disorders and cognitive impairment in patients with HIV-infection on ART for >12 months, compared to HIV- controls.

Depression, anxiety, substance abuse and PTSD are common in people living with HIV (PLWH). High incidence of these conditions has been associated with poor adherence to ART and disease progression. The high prevalence of these conditions and associations with cognitive function have not yet been studied in virally suppressed PLWH in comparison with controls.

Subjects participated in a natural history study that included a comprehensive NP battery and a detailed psychiatric inventory (Client Diagnostic Questionnaire) to screen for past and current mental health diagnosis and treatment. HIV+ subjects were on ART for at least 1 year. T-tests were used to compare results.

There were no significant differences in age, race or ethnicity between the HIV+ (n=155) and HIV- groups (n=51). There were more women in the HIV- group (49.0% vs. 32.9%, p=0.04). The HIV+ group reported having received treatment for depression significantly more than matched controls (27.45%, 50% respectively, p<0.01). Beck Depression Inventory II scores for HIV+ were also significantly higher compared to HIV- (median 3, 7, respectively, p<0.01).  Additionally, treatment histories for anxiety and PTSD were significantly higher in the HIV+ group (p=0.01, p=0.03, respectively) as well as for drug abuse and alcohol abuse (p<0.01, p=0.01). However, there were no significant differences in rates of HAND or abnormal GDS between the HIV+ and HIV- groups (p=0.88, p=0.97, respectively).

PLWH have higher rates of mental health and substance abuse disorders requiring treatment compared to HIV- controls. Despite this disproportionate burden of psychiatric disorders, the difference in cognitive function between the two groups remains minimal. Mental health disorders should be considered a clinically significant outcome that may be amenable to treatment even in those without cognitive impairment.