Study to assess the prevalence, nature and extent of cognitive impairment in people living with AIDS.

BACKGROUND

HIV directly affects the brain and produces varied psychiatric manifestations. 10-30% of patients with AIDS were found to have cognitive impairment and the virus is isolated in the CSF in 70% of AIDS patients.

AIM: The present study is aimed at finding out the prevalence, nature, and extent of cognitive changes in AIDS patients.

MATERIALS AND

METHODS

The consecutive sample of 33 patients with AIDS attending the ART center of our college were clinically interviewed and administered MMSE, BGT, Wechsler Memory Scale, and International HIV Dementia Scale.

RESULTS

In clinical assessment, only 1/33 (3%) patients could be diagnosed as dementia in HIV disease (ICD10-F02.4). This confirms the current Indian reports which indicate a lower prevalence of HIV dementia in our population. 2/33 (6%) patients were recognized to have mild cognitive disorder due to HIV disease (ICD10-F06.7). Asymptomatic cognitive impairment is very common in AIDS patients and it was noted in 69% of our study population. In the tests, MMSE was positive in only 3 of the 33 patients (9%) and it was not helpful to recognize cognitive deficits in our patients. The Wechsler Memory Scale was abnormal in 18 of the 33 patients (55%). BGT was abnormal in 48.5% of patients. The International HIV Dementia Scale was the most sensitive instrument and 63.6% the patients had abnormal scores in this scale.

CONCLUSION

Tests which assess cognitive and motor speed may be more helpful than clinical psychiatric interview to spot the AIDS patients who have cognitive impairment.