Declining Prevalence of Human Immunodeficiency Virus (HIV)–Associated Neurocognitive Disorders in Recent Years and Associated Factors in a Large Cohort of Antiretroviral Therapy–Treated Individuals With HIV
| العنوان: | Declining Prevalence of Human Immunodeficiency Virus (HIV)–Associated Neurocognitive Disorders in Recent Years and Associated Factors in a Large Cohort of Antiretroviral Therapy–Treated Individuals With HIV |
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| المؤلفون: | Ilaria Mastrorosa, Carmela Pinnetti, Anna Clelia Brita, Annalisa Mondi, Patrizia Lorenzini, Giulia Del Duca, Alessandra Vergori, Valentina Mazzotta, Roberta Gagliardini, Marta Camici, Federico De Zottis, Marisa Fusto, Maria Maddalena Plazzi, Elisabetta Grilli, Rita Bellagamba, Stefania Cicalini, Andrea Antinori |
| المصدر: | Clinical Infectious Diseases. 76:e629-e637 |
| بيانات النشر: | Oxford University Press (OUP), 2022. |
| سنة النشر: | 2022 |
| مصطلحات موضوعية: | Microbiology (medical), Infectious Diseases |
| الوصف: | Background HIV-associated neurocognitive disorders (HAND) have been suggested as persistent even with effective antiretroviral therapy (ART). Aims were to evaluate HAND prevalence and associated factors, in a large cohort of people-with-HIV (PWH). Methods ART-treated PWH, underwent a neuropsychological examination through a battery of 12 tests exploring 5 different domains, between 2009 and 2020, were included in this cross-sectional analysis. HAND were classified according to Frascati's criteria. Participants were defined as complaining or not-complaining if a cognitive complaint was reported or not. Chi-square for trend and multivariable logistic regression were fitted. Results Overall, 1424 PWH were enrolled during four three-years periods. HAND prevalence was 24%; among complainers (572/1424), it was 38%, higher than among not-complainers (15%). Over the study period, a decreasing HAND prevalence was found in the entire population (P < 0.001) and in complaining (P < 0.001); in not-complaining it remained stable (P = 0.182). Factors associated with HAND were older age, lower educational level, lower current CD4+ T-cell count and HCV co-infection. Compared to nonnucleoside reverse transcriptase inhibitors, receiving dual and integrase strand transfer inhibitor (INSTI)-based therapies was associated with a decreased risk of HAND, as well as being tested in more recent years. Conclusions In this large cohort of ART-treated PWH, mostly virologically suppressed, a remarkable decreasing HAND prevalence was observed. Besides HIV- and patient-related factors, the reduced risk of HAND found with dual and INSTI-based regimens along with a more recent ART initiation, could suggest a potential role of new treatment strategies in this decline, due to their greater virologic efficacy and better tolerability. |
| تدمد: | 1537-6591 1058-4838 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_________::1de4f3d6c958a6dc6c3e3ada5f5d650c https://doi.org/10.1093/cid/ciac658 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi...........1de4f3d6c958a6dc6c3e3ada5f5d650c |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15376591 10584838 |
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