Predictors of symptomatic HIV-associated neurocognitive disorders in universal health care
Objectives: The aim of the study was to determine the risk factors predictive of symptomatic HIV-associated neurocognitive disorders (sHAND) among HIV-infected patients receiving active medical care. Methods: Baseline demographic and clinical characteristics were analysed in patients with sHAND (HIV...
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th-mahidol.325522018-10-19T12:33:36Z Predictors of symptomatic HIV-associated neurocognitive disorders in universal health care Ja Mccombe P. Vivithanaporn Mj Gill C. Power University of Alberta Mahidol University Southern Alberta Clinic University of Calgary Medicine Objectives: The aim of the study was to determine the risk factors predictive of symptomatic HIV-associated neurocognitive disorders (sHAND) among HIV-infected patients receiving active medical care. Methods: Baseline demographic and clinical characteristics were analysed in patients with sHAND (HIV-associated dementia and minor neurocognitive disorder) in a population-based longitudinal cohort of HIV-infected patients with access to universal health care, including combination antiretroviral therapy (cART) from 1999 to 2008. Variables evaluated for their association with sHAND included age and ethnicity, survival duration with HIV-1 infection, vascular disease risk factors, and laboratory indices such as blood CD4 T-cell count at its nadir and at cART initiation, using both univariable and multivariable logistic regression models. Results: A total of 1320 patients were investigated, including the patients diagnosed with sHAND (n=90) during the study period. In univariable analyses, increased age, increased length of survival with HIV, low nadir CD4 and CD8 T-cell counts, high baseline viral load (>1000000 HIV-1 RNA copies/mL), and African origin were predictive of a diagnosis of sHAND (P<0.05). In multivariable analysis, increased age, increased length of survival, low nadir CD4 T-cell counts, and high baseline viral load remained predictive of sHAND (P<0.05). Remarkably, CD4 T-cell counts at cART initiation, hepatitis C virus coinfection, and vascular disease risk factors failed to predict sHAND in both analyses. Conclusions: Increased age and survival duration, lower nadir CD4 T-cell counts, and higher baseline viral load were consistent predictors of the development of sHAND among persons with HIV/AIDS in universal health care, underscoring the importance of attention to these variables in clinical care. © 2012 British HIV Association. 2018-10-19T05:33:35Z 2018-10-19T05:33:35Z 2013-02-01 Article HIV Medicine. Vol.14, No.2 (2013), 99-107 10.1111/j.1468-1293.2012.01043.x 14681293 14642662 2-s2.0-84871934278 https://repository.li.mahidol.ac.th/handle/123456789/32552 Mahidol University SCOPUS https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84871934278&origin=inward |
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Medicine Ja Mccombe P. Vivithanaporn Mj Gill C. Power Predictors of symptomatic HIV-associated neurocognitive disorders in universal health care |
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Objectives: The aim of the study was to determine the risk factors predictive of symptomatic HIV-associated neurocognitive disorders (sHAND) among HIV-infected patients receiving active medical care. Methods: Baseline demographic and clinical characteristics were analysed in patients with sHAND (HIV-associated dementia and minor neurocognitive disorder) in a population-based longitudinal cohort of HIV-infected patients with access to universal health care, including combination antiretroviral therapy (cART) from 1999 to 2008. Variables evaluated for their association with sHAND included age and ethnicity, survival duration with HIV-1 infection, vascular disease risk factors, and laboratory indices such as blood CD4 T-cell count at its nadir and at cART initiation, using both univariable and multivariable logistic regression models. Results: A total of 1320 patients were investigated, including the patients diagnosed with sHAND (n=90) during the study period. In univariable analyses, increased age, increased length of survival with HIV, low nadir CD4 and CD8 T-cell counts, high baseline viral load (>1000000 HIV-1 RNA copies/mL), and African origin were predictive of a diagnosis of sHAND (P<0.05). In multivariable analysis, increased age, increased length of survival, low nadir CD4 T-cell counts, and high baseline viral load remained predictive of sHAND (P<0.05). Remarkably, CD4 T-cell counts at cART initiation, hepatitis C virus coinfection, and vascular disease risk factors failed to predict sHAND in both analyses. Conclusions: Increased age and survival duration, lower nadir CD4 T-cell counts, and higher baseline viral load were consistent predictors of the development of sHAND among persons with HIV/AIDS in universal health care, underscoring the importance of attention to these variables in clinical care. © 2012 British HIV Association. |
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University of Alberta |
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University of Alberta Ja Mccombe P. Vivithanaporn Mj Gill C. Power |
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Article |
author |
Ja Mccombe P. Vivithanaporn Mj Gill C. Power |
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Ja Mccombe |
title |
Predictors of symptomatic HIV-associated neurocognitive disorders in universal health care |
title_short |
Predictors of symptomatic HIV-associated neurocognitive disorders in universal health care |
title_full |
Predictors of symptomatic HIV-associated neurocognitive disorders in universal health care |
title_fullStr |
Predictors of symptomatic HIV-associated neurocognitive disorders in universal health care |
title_full_unstemmed |
Predictors of symptomatic HIV-associated neurocognitive disorders in universal health care |
title_sort |
predictors of symptomatic hiv-associated neurocognitive disorders in universal health care |
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2018 |
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https://repository.li.mahidol.ac.th/handle/123456789/32552 |
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1763494908642983936 |