Risk Factors Associated With Incident Dementia in People Living With HIV

Cognitive decline often follows human immunodeficiency virus (HIV) infection. The objective of this study was to explore the factors present at HIV diagnosis associated with the risk of incident dementia.

A longitudinal observational study was conducted using a nationwide claim database (2008-2021). A cohort was designed using new diagnosis of HIV infection with antiretroviral therapy. Included in the analysis were individuals aged over 40, with > 3-year follow-up and without a diagnosis of dementia within 2 months post-HIV diagnosis. Dementia was defined as diagnosis and prescription of anti-dementia medication. Cox proportional hazards regression models assessed the association between baseline characteristics and the risk of incident dementia.

Among the 13,289 HIV-infected cohort, 3,929 met the inclusion criteria. The median age was 45 (interquartile range [IQR], 15), and 90.9% were male. During the median follow-up period of 7.6 (IQR, 5.0) years, dementia developed in 114 patients, with cumulative incidence reaching 4% at the 10-year follow-up. The development of dementia was associated with age at diagnosis ≥ 50 (hazard ratio [HR], 2.31; 95% confidence interval [CI], 1.51-3.53), low socioeconomic status (HR, 3.50; 95% CI, 2.22-5.52), and acquired immune deficiency syndrome (AIDS) status at diagnosis (HR, 2.05; 95% CI, 1.38-3.03).

This study underscores the importance of age at HIV diagnosis, socioeconomic status, and AIDS status as determinants of the risk of incident dementia among people living with HIV.