Salis Francesco, Belfiori Maristella, Bellisai Alice, Bernardini Eleonora, Murtas Michele, Piras Rossella, Serreli Silvia, Ortu Francesco, Piano Paola, Del Giacco Stefano, Mandas Antonella
Department of Medical Sciences and Public Health, University of Cagliari, SS 554 bivio Sestu, 09042 Cagliari, Italy.
Department of Biomedical Sciences, University of Cagliari, 09042 Cagliari, Italy.
J Clin Med. 2024 Mar 13;13(6):1631. doi: 10.3390/jcm13061631.
: Human Immunodeficiency Virus (HIV) infection represents a significant public health concern and, consequently, the incidence of HIV-Associated Neurocognitive Disorder (HAND) has grown over the years. The present study aims to assess HAND with the Montreal Cognitive Assessment (MoCA) in People Living With HIV/AIDS (PLWHA) to find significant associations with cognitive impairment. : The study included 210 PLWHA, aged from 30 to 81 years, of whom, 137 (65.2%) were males. They were assessed at the Immunology Service of the University Hospital of Monserrato, Cagliari, Italy, between November 2022 and April 2023. : The sample showed an overall optimal response to antiretroviral therapy, as shown by the excellent levels of CD4+ lymphocytes and HIV RNA copies. A sum of 115 subjects (54.8%) were considered cognitively impaired and the multivariate analysis demonstrated that it was independently associated with duration of infection (OR: 0.96), age (OR: 1.12), alanine aminotransferase (ALT) (OR: 1.02), and depression (OR: 1.33). By dichotomizing the variables, the significance of the association was confirmed for age (65-year threshold) (χ: 5.142, = 0.0233) and depression (χ: 7.834, = 0.0051). : Our study demonstrates that it is hard to find both statistically and clinically significantly associated variables with cognitive impairment in PLWHA, and that the strongest independent association is with depressed mood.
人类免疫缺陷病毒(HIV)感染是一个重大的公共卫生问题,因此,多年来与HIV相关的神经认知障碍(HAND)的发病率一直在上升。本研究旨在使用蒙特利尔认知评估量表(MoCA)对HIV/AIDS患者(PLWHA)的HAND进行评估,以找出与认知障碍的显著关联。
该研究纳入了210名年龄在30至81岁之间的PLWHA,其中137名(65.2%)为男性。他们于2022年11月至2023年4月期间在意大利卡利亚里蒙塞拉托大学医院的免疫学服务部门接受了评估。
样本显示对抗逆转录病毒治疗的总体反应良好,这从CD4+淋巴细胞和HIV RNA拷贝的优异水平可以看出。共有115名受试者(54.8%)被认为存在认知障碍,多变量分析表明,认知障碍与感染持续时间(比值比:0.96)、年龄(比值比:1.12)、丙氨酸转氨酶(ALT)(比值比:1.02)和抑郁(比值比:1.33)独立相关。通过对变量进行二分法分析,年龄(65岁阈值)(卡方值:5.142,P = 0.0233)和抑郁(卡方值:7.834,P = 0.0051)的关联显著性得到了证实。
我们的研究表明,在PLWHA中很难找到在统计学和临床上与认知障碍显著相关的变量,并且最强的独立关联是与情绪低落相关。