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[以色列HIV-1阳性患者中的神经认知障碍和精神疾病]

[Neurocognitive disturbances and psychiatric disorders among patients living with HIV-1 positive in Israel].

作者信息

Levy Itzchak, Goldstein Alon, Fischel Tsvi, Maor Yasmin, Litachevsky Vladislav, Rahav Galia

机构信息

Sheba Medical Center, Tel Hashamer, Israel.

出版信息

Harefuah. 2013 Apr;152(4):196-9, 248-9.

Abstract

INTRODUCTION

Neurocognitive dysfunction and psychiatric disorders are common among people living with HIV. A large number of the patients are asymptomatic, but in neurocognitive assessment and specific questionnaires subclinical disturbances can be diagnosed. The aim of this research was to study the rate of neurocognitive disturbances, as well as psychiatric disorders (depression and anxiety) among Israeli people living with HIV, and to find predictors for these disturbances.

METHODS

VaLidated neurocognitive tests and psychiatric assessment questionnaires (PHQ-9 and STAI) were conducted among 57 asymptomatic HIV-1 positive patients. Sociodemographic and clinical characteristics were collected from the patients' files.

RESULTS

The rate of disturbances in the neurocognitive test was dependent on the test used. Whereas in Trail making A and B (TMA, TMB) high rates of disturbances were found, almost no patients with disturbances were found when the digit symbol substitution test (DSST) was used. In immediate and delayed memory testing (IMT and DMT) 47.7% and 49% memorized less than 75% of the numbers, respectively, while 18% of the patients had anxiety and 24% suffered from depression. The median quality of life measured by the analog scale was 7. In multivariate analysis we could not find predictive variables for neurocognitive or psychiatric disorders.

DISCUSSION

Neurocognitive disturbances and psychiatric disorders are common among asymptomatic people living with HIV, irrelevant of the time of being positive, immunoLogical status, viral load or treatment received.

摘要

引言

神经认知功能障碍和精神疾病在艾滋病毒感染者中很常见。大量患者没有症状,但在神经认知评估和特定问卷中可诊断出亚临床障碍。本研究的目的是研究以色列艾滋病毒感染者中神经认知障碍以及精神疾病(抑郁症和焦虑症)的发生率,并找出这些障碍的预测因素。

方法

对57名无症状的HIV-1阳性患者进行了有效的神经认知测试和精神评估问卷(PHQ-9和STAI)。从患者档案中收集社会人口统计学和临床特征。

结果

神经认知测试中的障碍发生率取决于所使用的测试。在连线测验A和B(TMA、TMB)中发现了较高的障碍发生率,而使用数字符号替换测验(DSST)时几乎没有发现有障碍的患者。在即时和延迟记忆测试(IMT和DMT)中,分别有47.7%和49%的患者记住的数字少于75%,而18%的患者有焦虑症,24%的患者患有抑郁症。用模拟量表测量的生活质量中位数为7。在多变量分析中,我们未能找到神经认知或精神疾病的预测变量。

讨论

神经认知障碍和精神疾病在无症状的艾滋病毒感染者中很常见,与感染阳性时间、免疫状态、病毒载量或接受的治疗无关。

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