Department of Internal Medicine and Public Health, University of Cagliari, Cagliari, Italy.
AIDS Care. 2021 Mar;33(3):357-363. doi: 10.1080/09540121.2020.1742859. Epub 2020 Mar 17.
HIV-infected people are at risk for neurocognitive impairment (HIV-Associated Neurocognitive Disorders - HAND). To evaluate whether the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), a widely used neurocognitive screening tool, could be a valid instrument for HAND identification, we evaluated 166 HIV-infected subjects. Our results showed that 96 (57.8%) HIV-infected scored RBANS Total Index Score <85 (at least one SD below the normal), 12 (7.2%) of them scored RBANS Total Index Score <70 (at least 2 SD below the normal, indicating a possible HIV-Associated Dementia). The more compromised areas were Immediate and Delayed Memory, and Attention. In the group with RBANS Total Index Score <85, there were significantly lower scores of Mini Mental State Examination ( = 0.0008), Clock Drawing Test ( = 0.0015) and higher score of Geriatric Depression Scale ( = 0.02) compared to the RBANS Total Index Score ≥85 group. Using a stepwise logistic regression, considering RBANS Total Index Score as dependent variable, we found a positive interaction with tenofovir/emtricitabine assumption ( = 0.027), Clock Drawing Test ( = 0.0125) and educational level ( = 0.0054). Being the viro-immunological markers not capable of predicting cognitive decline in HIV-infected individuals, our data suggest that RBANS may be a valid tool for the early identification of HIV-related cognitive impairment.
HIV 感染者存在神经认知障碍(HIV 相关神经认知障碍 - HAND)的风险。为了评估广泛使用的神经认知筛选工具重复认知评估电池(RBANS)是否可作为 HAND 识别的有效工具,我们评估了 166 名 HIV 感染者。我们的结果表明,166 名 HIV 感染者中有 96 名(57.8%)的 RBANS 总指数评分<85(低于正常水平一个标准差),其中 12 名(7.2%)的 RBANS 总指数评分<70(低于正常水平两个标准差,表明可能存在 HIV 相关痴呆)。受影响更严重的领域是即时和延迟记忆以及注意力。在 RBANS 总指数评分<85 的组中,与 RBANS 总指数评分≥85 的组相比,简易精神状态检查( = 0.0008)、画钟测验( = 0.0015)得分显著降低,而老年抑郁量表得分更高( = 0.02)。使用逐步逻辑回归,考虑 RBANS 总指数评分作为因变量,我们发现与替诺福韦/恩曲他滨的假设( = 0.027)、画钟测验( = 0.0125)和教育程度( = 0.0054)呈正交互作用。由于病毒免疫标志物不能预测 HIV 感染者的认知下降,我们的数据表明 RBANS 可能是早期识别 HIV 相关认知障碍的有效工具。