Department of Physiotherapy, Faculty of Health Sciences, University of Pretoria, Pretoria, 0028, Hatfield, South Africa.
Department of Basic Medical Sciences, Durban University of Technology, Durban, South Africa.
Sci Rep. 2022 Apr 19;12(1):6470. doi: 10.1038/s41598-022-10474-8.
HIV-associated neurocognitive disorder (HAND) is an important sequela of HIV infection. Combined antiretroviral therapy (cART) has improved the health outcomes of many people living with HIV but has given rise to a less severe but limiting form of HAND. The study aimed to evaluate the impact of HAND on medication adherence, activities of daily living (ADL), quality of life and frailty. This systematic review adheres to the guidelines for Preferred Reporting Items for Systematic Reviews and Meta-Analyses. We searched MEDLINE, PubMed, CINAHL, Academic Search Complete, and PsycINFO online databases. Studies were included if they examined the relationship between HAND and medication adherence, ADL, quality of life and frailty, and were conducted between 1997 and 2021. We used a random-effects meta-analysis model to assess the impact of HAND on outcome variables. Forty papers, totaling 11,540 participants, were included in the narrative and quantitative syntheses. Cognitive impairment was associated with poorer medication adherence (r = 0.601, CI 0.338 to 0.776, p = 0.001, I = 94.66). Cognitive impairment did not influence ADL (r = 0.167, CI-0.215 to 0.505, p = 0.393) and quality of life (r = 0.244, CI 0.117 to 0.548, p = 0.182). In the cART era, HAND appears to be associated with adherence to medication, which may influence future health outcomes. In PLWHIV who are adherent to cART, cognitive impairment does not appear to interfere with ADL and quality of life.
HIV 相关神经认知障碍（HAND）是 HIV 感染的重要后遗症。联合抗逆转录病毒疗法（cART）改善了许多 HIV 感染者的健康状况，但也导致了一种不太严重但更具限制的 HAND 形式。本研究旨在评估 HAND 对药物依从性、日常生活活动（ADL）、生活质量和虚弱的影响。本系统评价符合系统评价和荟萃分析的首选报告项目指南。我们搜索了 MEDLINE、PubMed、CINAHL、Academic Search Complete 和 PsycINFO 在线数据库。如果研究考察了 HAND 与药物依从性、ADL、生活质量和虚弱之间的关系，并且在 1997 年至 2021 年之间进行，则纳入研究。我们使用随机效应荟萃分析模型来评估 HAND 对结局变量的影响。40 篇论文，共计 11540 名参与者，纳入了叙述性和定量综合分析。认知障碍与较差的药物依从性相关（r=0.601，CI 0.338 至 0.776，p=0.001，I=94.66）。认知障碍不影响 ADL（r=0.167，CI-0.215 至 0.505，p=0.393）和生活质量（r=0.244，CI 0.117 至 0.548，p=0.182）。在 cART 时代，HAND 似乎与药物依从性相关，这可能会影响未来的健康结局。在 cART 依从性良好的 PLWHIV 中，认知障碍似乎不会干扰 ADL 和生活质量。
