Related Experiment Video
Updated: Jun 18, 2025
07:27
Exergaming in Older People Living with HIV Improves Balance, Mobility and Ameliorates Some Aspects of Frailty
Published on: October 6, 2016
10.2K
Symptomatic and Asymptomatic Neurocognitive Impairment, ART Adherence and HIV Control: A 4-Year Observational Study
Mattia Trunfio1,2, Elisa Vuaran3, Daniela Vai4
1Unit of Infectious Diseases, Department of Medical Sciences, Amedeo di Savoia Hospital, University of Turin, Corso Svizzera 164, Turin, IT, 10149, Italy. mtrunfio@health.ucsd.edu.
AIDS and Behavior
|July 30, 2024
Summary
Neurocognitive impairment (NCI), even when asymptomatic, significantly impacts HIV viral control in individuals on antiretroviral therapy (ART). Poor adherence to ART partially explains this relationship, highlighting the clinical relevance of NCI.
Area of Science:
- Neuroscience and Infectious Diseases
- HIV/AIDS Research
- Cognitive Health in Chronic Illness
Background:
- Neurocognitive impairment (NCI) is a known complication in people living with HIV (PLWH).
- The clinical significance of asymptomatic NCI on HIV disease progression, particularly viral control, remains debated.
- Antiretroviral therapy (ART) adherence is crucial for maintaining viral suppression in PLWH.
Purpose of the Study:
- To evaluate the impact of symptomatic and asymptomatic neurocognitive impairment (NCI) on HIV viral control.
- To investigate the mediating role of ART adherence in the relationship between NCI and viral control.
- To assess the long-term viral control outcomes in relation to NCI severity.
Main Methods:
- An observational study involving 322 PLWH on ART, analyzing viral load (VL) data over a 4-year period around neurocognitive evaluation (NCE).
- NCI was assessed using Frascati criteria; viral control was categorized (undetectable, VLLV, LLV, HLV) and classified as persistent, viral failure, or optimal.
- Mediation analyses were employed to examine the role of ART adherence, with adjusted models accounting for confounding factors.
Main Results:
- 41.6% and 10.8% of participants presented with asymptomatic and symptomatic NCI, respectively.
- Both symptomatic and asymptomatic NCI were independently associated with increased risk of viral failure and persistent low-level/very low-level viremia.
- ART adherence partially mediated the association between NCI and poorer viral control, with increasing NCI severity correlating with worse viral control.
Conclusions:
- Both symptomatic and asymptomatic neurocognitive impairment are significant independent predictors of suboptimal HIV viral control.
- ART adherence plays a partial mediating role in the link between NCI and impaired viral control.
- The current classification of 'asymptomatic' NCI may underestimate clinical risks, necessitating closer monitoring and intervention.
Keywords:
AdherenceFrascati criteriaHIV-associated neurocognitive disordersNeurocognitive impairmentViral failureViral suppression
