Haddow L J, Accoroni A, Cartledge J D, Manji H, Benn P, Gilson R J C
Centre for Sexual Health and HIV Research, Research Department of Infection and Population Health, University College London.
Int J STD AIDS. 2013 Mar;24(3):217-9. doi: 10.1177/0956462412472452. Epub 2013 May 6.
We estimated the burden of HIV-associated neurocognitive disorders (HAND) in a UK clinic. From a random sample, and referrals to specialist services over one year (neurology, clinical psychology, hospital admissions), we determined whether patients were diagnosed with HIV-associated dementia (HAD) and whether they reported symptoms suggesting neurocognitive impairment (NCI). In the first sample, 2/150 (prevalence 1.3%; 95% confidence interval [CI] 0.2-4.7%) had documented HAD. Eleven patients (7.3%; CI 3.7-12.7%) reported recent symptoms suggesting NCI; most of these individuals were diagnosed with a psychiatric or substance-use disorder. Among specialist referrals with symptoms suggesting NCI, 11 were diagnosed with HAD from a clinic population of 3129 individuals (annual incidence 0.4%; CI 0.2-0.6%). No patients with mildly symptomatic or asymptomatic HAND were identified in either sample, suggesting that such patients remain undetected in current clinical practice. Evidence-based screening for HAND in HIV clinics may be needed.
我们在一家英国诊所评估了与艾滋病病毒相关的神经认知障碍（HAND）的负担。通过随机抽样以及对一年多来专科服务的转诊情况（神经科、临床心理学、住院情况），我们确定患者是否被诊断为艾滋病病毒相关痴呆（HAD），以及他们是否报告了提示神经认知障碍（NCI）的症状。在第一个样本中，150人中有2人（患病率1.3%；95%置信区间[CI]0.2 - 4.7%）有记录在案的HAD。11名患者（7.3%；CI 3.7 - 12.7%）报告了近期提示NCI的症状；这些个体中的大多数被诊断为精神疾病或物质使用障碍。在有提示NCI症状的专科转诊患者中，在3129名诊所患者中有11人被诊断为HAD（年发病率0.4%；CI 0.2 - 0.6%）。在两个样本中均未发现有轻度症状或无症状的HAND患者，这表明此类患者在当前临床实践中仍未被发现。可能需要在艾滋病病毒诊所对HAND进行循证筛查。
