A Comparative Study of the Profile of Cognitive Impairment and Associated Factors among Subsets of Human Immunodeficiency Virus Patients in a Special Human Immunodeficiency Virus Clinic in South-East Nigeria

Abstract

CONTEXT: The human immunodeficiency virus (HIV) is a neurotropic virus with several neurological manifestations including cognitive impairment. AIMS: This study aimed to determine and compare the frequency of cognitive impairment and associated factors among subsets of HIV-positive patients and matched controls using neuropsychological test battery. SETTINGS AND DESIGN: This was a comparative cross-sectional descriptive study conducted in a Southeastern Nigerian Special HIV clinic. SUBJECTS AND METHODS: Two subsets of HIV patients; the combination antiretroviral therapy (CART) experienced patients and the CART naïve patients and matched HIV negative subjects were surveyed using the World Health Organization/University of California, Los Angeles neuropsychological test battery. STATISTICAL ANALYSIS: Statistical Package for the Social Science version 20.0 was used. RESULTS: The overall frequency of neurocognitive impairment was 76.1% (mild 44.6% and moderate-to-severe cognitive 31.5%). Although there was no statistically significant difference in the percentages of CART naïve patients (76.3%; n = 29/38) and CART-exposed (75.9%, n = 41/54) that had cognitive impairment, severe cognitive impairment was more among the CART naïve patients (44.4%; n = 24/54) and mild cognitive impairment more among CART-exposed (63.1%; n = 24/38). CART-exposed patients had better scores in most of the subtests of the battery compared to CART-naïve patients but the observed difference was not statistically significant. The observed relationship between cognitive impairment and age, sex, or level of education was also not statistically significant. CONCLUSION: HIV-associated neurocognitive impairment is still common in HIV patients and treatment with ART may reduce its severity.