Short-term neurocognitive changes among people living with HIV assessed using the International HIV Dementia Scale.

BACKGROUND

Neurocognitive dysfunction remains an important complication among people living with HIV (PLWH). Early identification of neurocognitive dysfunction by using the International HIV Dementia Scale (IHDS) may help in the prevention of functional decline and poor treatment adherence. However, data on longitudinal changes in IHDS among PLWH are limited.

METHODS

This prospective longitudinal study was conducted among adult PLWH attending an ART centre. Neurocognitive function was assessed using the IHDS at baseline and after a two-month follow-up. Patients with IHDS ≤10 were considered to have neurocognitive dysfunction. The primary outcome was the change in IHDS over a 2-month follow-up.

RESULTS

A total of 61 patients were followed for a period of two months. The median age of the study population was 41 years (IQR:34-56), with a median CD4 count of 287 cells/μL (IQR:178-387). The prevalence of neurocognitive dysfunction in PLWH was 44.3%. The improvement in IHDS scores during a two-month follow-up was, although small, statistically significant (p = 0.0023). The correlation between IHDS and baseline CD4 was statistically significant (p = 0.012). However, we did not find a significant correlation between IHDS and age or duration of ART (p = 0.215 and 0.732, respectively). The IHDS scores were significantly correlated with the depressive symptoms (p = 0.003).

CONCLUSIONS

IHDS scores showed a modest improvement over the short-term follow-up. However, a change in IHDS was not associated with ART duration or short-term change in CD4 counts. Longer-term studies using detailed neurocognitive assessment tools are required to understand better the magnitude and clinical significance of neurocognitive changes among PLWH.