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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
Summary
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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