Troncoso Flávio Trentin, Conterno Lucieni de Oliveira
Disciplina de Infectologia, Faculdade de Medicina de Marília, Marília, São Paulo, BR.
Rev Soc Bras Med Trop. 2015 Jul-Aug;48(4):390-8. doi: 10.1590/0037-8682-0034-2015.
Combined antiretroviral therapy has enabled human immunodeficiency virus (HIV) carriers to live longer. This increased life expectancy is associated with the occurrence of degenerative diseases, including HIV-associated neurocognitive disorders (HAND), which are diagnosed via a complex neuropsychological assessment. The International HIV Dementia Scale (IHDS) is a screening instrument validated in Brazil for use in the absence of neuropsychological evaluation. HIV patients are frequently diagnosed with depression. We aimed to determine the prevalence of neurocognitive impairment using the IHDS and depressive disorders using the Hamilton Rating Scale for Depression (HAM-D17), compare the IHDS performance with the performances on the Timed Gait Test (TGT), the Digit Symbol Coding Test (DS) and the Brazilian version of the Scale of Instrumental Activities of Daily Living (IADL), and evaluate the association between the IHDS performance and clinical-demographic variables.
One hundred fourteen patients were evaluated in a cross-sectional study conducted in a public outpatient clinic for infectious diseases in Marília City, State of São Paulo, Brazil. Data were collected following consultation. Statistical analysis was performed in accordance with the nature and distribution of the data and hypotheses.
According to the IHDS, 53.2% of the sampled patients were neuropsychologically impaired. According to the HAM-D17, 26.3% had depressive disorders. There were significant associations between the IHDS and the TGT and DS. Multiple regression analysis indicated that female gender, educational level, and cluster of differentiation 4 (CD4) levels were significantly and independently associated with neurocognitive impairment.
The prevalence of neurocognitive impairment according to the IHDS is high and associated with female gender, education level, and low CD4 levels.
联合抗逆转录病毒疗法使人类免疫缺陷病毒（HIV）携带者的寿命得以延长。预期寿命的增加与退行性疾病的发生相关，包括HIV相关神经认知障碍（HAND），其通过复杂的神经心理学评估进行诊断。国际HIV痴呆量表（IHDS）是一种在巴西经过验证的筛查工具，可在无神经心理学评估的情况下使用。HIV患者常被诊断出患有抑郁症。我们旨在使用IHDS确定神经认知障碍的患病率，并使用汉密尔顿抑郁量表（HAM-D17）确定抑郁症的患病率，将IHDS的表现与定时步态测试（TGT）、数字符号编码测试（DS）以及巴西版日常生活活动能力量表（IADL）的表现进行比较，并评估IHDS表现与临床人口统计学变量之间的关联。
在巴西圣保罗州马利利亚市的一家公共传染病门诊进行的一项横断面研究中，对114名患者进行了评估。咨询后收集数据。根据数据的性质、分布和假设进行统计分析。
根据IHDS，53.2%的抽样患者存在神经心理学损伤。根据HAM-D17，26.3%的患者患有抑郁症。IHDS与TGT和DS之间存在显著关联。多元回归分析表明，女性性别、教育水平和分化簇4（CD4）水平与神经认知障碍显著且独立相关。
根据IHDS，神经认知障碍的患病率很高，且与女性性别、教育水平和低CD4水平相关。
