Wubetu Abate Dargie, Asefa Kokebie Kefelegn, Gebregiorgis Birhan Gebresillassie
Debre Berhan University, College of Health Science, Department of Psychiatry, Debre Berhan, Ethiopia.
Debre Berhan University, College of Health Science, Department of Nursing, Debre Berhan, Ethiopia.
HIV AIDS (Auckl). 2021 Apr 16;13:425-433. doi: 10.2147/HIV.S298141. eCollection 2021.
The burden of HIV is mainly found in Sub Saharan Africa. The HIV-associated neurocognitive impairment is found to be higher and it can exist at all stages of HIV. The HIV-associated neurocognitive impairment has a significant impact on a patient's daily living and highly active antiretroviral treatment (HAART) adherence. Therefore, this study aimed to determine the prevalence and associated factors of HIV-associated neurocognitive impairment among adult people on HIV treatment.
A total of 423 people living with HIV/AIDS were planned to include in the study. A systematic random sampling technique was used to get the study participants. Binary logistic regression analysis was used to identify associated factors of HIV-associated neurocognitive impairment. Factors with a p-value of ≤ 0.2 on bivariate analyses were recruited for multivariate logistic regression analyses, and 95% CI at p-value < 0.05 was considered as statistically significant. Variance inflation factors for continuous variables and Spearman rank correlation for categorical variables were performed. There was no multicollinearity between suspected predictor variables. Model fitness was checked using Hosmer and Lemeshow Test, and its p-value was 0.45.
A total of 422 individuals on HAART were included which gave a response rate of 99.8%. The prevalence of HIV-associated neurocognitive impairment was 41% (95% CI=36.3, 45.6). Older individuals, low monthly income, having comorbid depression and anxiety, have no communication about safe sexual intercourse, higher duration of HIV illness, and having poor social support were statistically significant associated factors of HIV neurocognitive impairment.
Two among five HIV patients on HAART treatment experienced HIV-associated neurocognitive impairment. It will be better if health professionals working at the HIV/TB clinic screen and consult HIV patients for psychiatric evaluation and treatment. Due attention should be given to HIV patients with associated factors.
艾滋病毒的负担主要集中在撒哈拉以南非洲地区。人们发现，与艾滋病毒相关的神经认知障碍更为常见，且在艾滋病毒感染的各个阶段均可能出现。与艾滋病毒相关的神经认知障碍对患者的日常生活以及高效抗逆转录病毒治疗（HAART）的依从性都有重大影响。因此，本研究旨在确定接受艾滋病毒治疗的成年人中与艾滋病毒相关的神经认知障碍的患病率及其相关因素。
本研究计划纳入423名艾滋病毒/艾滋病患者。采用系统随机抽样技术选取研究参与者。使用二元逻辑回归分析来确定与艾滋病毒相关的神经认知障碍的相关因素。在双变量分析中p值≤0.2的因素被纳入多变量逻辑回归分析，p值<0.05时的95%置信区间被视为具有统计学意义。对连续变量进行方差膨胀因子分析，对分类变量进行Spearman等级相关性分析。疑似预测变量之间不存在多重共线性。使用Hosmer和Lemeshow检验检查模型拟合度，其p值为0.45。
总共纳入了422名接受HAART治疗的个体，应答率为99.8%。与艾滋病毒相关的神经认知障碍的患病率为41%（95%置信区间=36.3, 45.6）。年龄较大的个体、月收入较低、患有合并症抑郁症和焦虑症、未进行安全性行为沟通、艾滋病毒疾病病程较长以及社会支持较差是与艾滋病毒神经认知障碍具有统计学意义的相关因素。
接受HAART治疗的五名艾滋病毒患者中有两名经历了与艾滋病毒相关的神经认知障碍。如果在艾滋病毒/结核病诊所工作的卫生专业人员对艾滋病毒患者进行筛查并咨询其精神科评估和治疗，情况会更好。应给予具有相关因素的艾滋病毒患者应有的关注。
