Attention or memory deficits? An HIV study in Shanghai using local and norm-based controls

Area of Science:

• Neuroscience
• Public Health
• Infectious Diseases

Background:

• HIV-associated neurocognitive disorder (HAND) is a significant complication for people living with HIV (PLWH).
• Accurate diagnosis of HAND relies on standardized neuropsychological tests.
• The choice of healthy control groups critically affects the interpretation of these test results.

Purpose of the Study:

• To compare neurocognitive outcomes in PLWH using local HIV-negative controls versus historical norms.
• To evaluate neurocognitive impairments in a contemporary Shanghai population of PLWH.
• To assess the applicability of existing neuropsychological norms to current populations.

Main Methods:

• A cohort of 244 PLWH and 132 HIV-negative controls from Shanghai were assessed between 2019-2024.
• Standardized neuropsychological tests across seven cognitive domains were administered.
• Neurocognitive impairment was determined by comparison with local controls and established norms.

Main Results:

• Adjusted analyses revealed significantly lower scores in attention/working memory for PLWH compared to controls (p < 0.001).
• Executive function showed a marginal difference (p = 0.052), while other domains had no significant group differences.
• Norm-based analysis indicated higher impairment rates in memory (32%) and learning (20%) among PLWH, differing from local control findings.

Conclusions:

• Neurocognitive impairments in Shanghai PLWH predominantly affect attention/working memory and executive function.
• Discrepancies between local controls and outdated norms highlight limitations in current assessment methods.
• Developing updated, localized norms is crucial for accurate HAND diagnosis and effective intervention strategies.