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The case for cognitive screening in HIV clinics

P McNamara1, J Redmond, C Bergin

  • 1Department of Neurology, Hospital 5 HCC, St. James's Hospital, Dublin 8. pmcnamara@stjames.ie

Irish Medical Journal
|September 27, 2012
PubMed

Insights

This study found that using surrogate markers identified cognitive impairment in 13.8% of HIV patients. These markers are less effective than structured screening for assessing cognitive function in people with HIV.

Area of Science:

  • Neuroscience
  • Infectious Diseases
  • Public Health

Background:

  • Cognitive impairment is a concern in individuals with Human Immunodeficiency Virus (HIV).
  • Previous studies have explored various methods to assess cognitive function in this population.
  • Surrogate markers offer a potential, albeit less precise, way to identify cognitive issues.

Purpose of the Study:

  • To determine the prevalence of cognitive impairment in an HIV-positive cohort using surrogate markers.
  • To evaluate the effectiveness of surrogate markers compared to structured cognitive screening.
  • To identify factors associated with cognitive impairment in HIV patients.

Main Methods:

  • Retrospective chart review of 500 consecutive HIV patients at St. James's Hospital, Dublin.
  • Utilized surrogate markers including subjective complaints, new psychiatric diagnoses, neurological complications, and radiological atrophy.
  • Employed multivariate logistic regression analysis to explore associations with demographic and clinical factors.

Main Results:

  • 13.8% of patients (69/500) exhibited one or more positive surrogate markers for cognitive impairment.
  • Significant associations were found with gender and year of HIV diagnosis.
  • The prevalence identified by surrogate markers was lower than international rates, suggesting limited sensitivity.

Conclusions:

  • Surrogate markers are insufficient for accurately determining the prevalence of cognitive impairment in HIV-positive individuals.
  • Structured cognitive screening is a more reliable method for assessing cognitive function in this population.
  • The study highlights the need for improved diagnostic tools and has initiated prospective screening.

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