Evaluation of Cognitive Functions in People Living with HIV Before and After COVID-19 Infection

Cognitive function decline is a problem in aging people living with HIV (PLWHIV). COVID-19 infection is associated with neuropsychiatric manifestations that may persist. The aim of our study was to evaluate cognitive function in PLWHIV before and after COVID-19 infection.

This was a prospective observational study conducted at "Laiko" General Hospital from July 2019 to July 2024. The Montreal Cognitive Assessment (MOCA) scale was used to evaluate cognitive functions.

116 virally suppressed PLWHIV participated (mean age: 47.6 years, 91.4% male); 60 underwent repeated evaluation after the pandemic at a median interval of 3.1 years. The median MOCA score was 24 (22-26), with 35.3% scoring within normal limits. A negative correlation was observed between MOCA scores and age (ρ = -0.283, p = 0.002), but not with a CD4 count at diagnosis (ρ = 0.169, p = 0.071) or initial HIV RNA load (ρ = 0.02, p = 0.984). In the subgroup with repeated testing, MOCA was correlated with the CD4 count (ρ = 0.238, p = 0.069 in the first and ρ = 0.319, p = 0.014 second test). An improvement in performance was observed (median score increase from 24 to 25, p = 0.02).

MOCA can detect early changes in cognitive function in PLWHIV. Further studies are required to determine the role of COVID-19 over time.