Prevalence of HIV-associated neurocognitive disorders in the Multicenter AIDS Cohort Study

Ned Sacktor, Richard L. Skolasky, Eric Seaberg, Cynthia Munro, James T. Becker, Eileen Martin, Ann Ragin, Andrew Levine, Eric Miller

Research output: Contribution to journalArticlepeer-review

162 Scopus citations

Abstract

Objective: To evaluate the frequency of HIV-associated neurocognitive disorder (HAND) in HIV+ individuals and determine whether the frequency of HAND changed over 4 years of follow-up. Methods: The Multicenter AIDS Cohort Study (MACS) is a prospective study of gay/bisexual men. Beginning in 2007, all MACS participants received a full neuropsychological test battery and functional assessments every 2 years to allow for HAND classification. Results: The frequency of HAND for the 364 HIV+ individuals seen in 2007-2008 was 33% and for the 197 HIV+ individuals seen at all time periods during the 2007-2008, 2009-2010, and 2011-2012 periods were 25%, 25%, and 31%, respectively. The overall frequency of HAND increased from 2009-2010 to 2011-2012 (p 0.048). Over the 4-year study, 77% of the 197 HIV+ individuals remained at their same stage, with 13% showing deterioration and 10% showing improvement in HAND stage. Hypercholesterolemia was associated with HAND progression. A diagnosis of asymptomatic neurocognitive impairment was associated with a 2-fold increased risk of symptomatic HAND compared to a diagnosis of normal cognition. Conclusion: HAND remains common in HIV+ individuals. However, for the majority of HIV+ individuals on combination antiretroviral therapy with systemic virologic suppression, the diagnosis of HAND is not a progressive condition over 4 years of follow-up. Future studies should evaluate longitudinal changes in HAND and specific neurocognitive domains over a longer time period.

Original languageEnglish (US)
Pages (from-to)334-340
Number of pages7
JournalNeurology
Volume86
Issue number4
DOIs
StatePublished - Jan 26 2016

ASJC Scopus subject areas

  • Clinical Neurology

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