Background: To determine the prevalence of neurocognitive impairment (NCI) in UK HIV-positive and HIV-negative men who have sex with men (MSM).
Methods: HIV-positive and HIV-negative participants were recruited to a cross-sectional study from 2 London clinics and completed computerassisted neuropsychological tests and questionnaires of depression, anxiety, and activities of daily living. Published definitions of HIVassociated neurocognitive disorders (HAND) and global deficit scores were used. Age- and education-adjusted neuropsychological test scores were directly compared with reference population data.
Results: A total of 248 HIV-positive and 45 HIV-negative MSM participated. In the HIV-positive group, median time since diagnosis was 9.4 years, median CD4+ count was 550 cells per cubic millimeter, and 88% were on antiretroviral therapy. Prevalence of HAND was 21.0% in HIV-positive MSM (13.7% asymptomatic neurocognitive impairment, 6.5% mild neurocognitive disorder, and 0.8% HIVassociated dementia). Using a global deficit score threshold of 0.5, the prevalence of NCI was 31.5% (when averaged over 5 neuropsychological domains) and 40.3% (over 10 neuropsychological test scores). These results were not significantly different from the HIV-negative study sample. No consistent pattern of impairment was seen in HIVpositive patients relative to general male population data (n = 380).
Conclusions: We found a prevalence of HAND and degree of impairment on neuropsychological testing of HIV-positive MSM that could represent a normal population distribution. These findings suggest that NCI may be overestimated in HIV-positive MSM, and that the attribution of NCI to HIV infection implied by the term HAND requires revision.
|Number of pages||8|
|Journal||Journal of Acquired Immune Deficiency Syndromes|
|Publication status||Published - 2014|
- Cognition disorders
- Cross-sectional studies
- HIV infections
- Men who have sex with men
- Neuropsychological tests
ASJC Scopus subject areas
- Infectious Diseases
- Pharmacology (medical)