Logistic regression-based parametric analysis of HIV-associated dementia using a screening tool in a tertiary care hospital in Mumbai

CONTEXT: The AIDS dementia complex is one of the most common and clinically important complications of HIV infection. Subclinical dementia not presenting with features of frank disease may be missed. The use of screening tools provides a good alternative to a psychiatrist's diagnosis in resource-limited settings like the site of this study. AIMS: The study aimed to analyze various parameters such as age, gender, duration of the disease, duration since treatment, clinical staging, CD4 count, mode of transmission, and comorbidities like tuberculosis with the prevalence of AIDS dementia complex in the participants. SETTINGS AND DESIGN: A cross-sectional study involving 180 participants was conducted over a duration of 18 months. MATERIALS AND METHODS: The assessment of dementia was done using the International HIV Dementia Scale. STATISTICAL ANALYSIS USED: Backward binomial logistics regression. RESULTS: Both duration of treatment and duration since diagnosis of HIV were found to be significantly associated with the presence of AIDS dementia. Patients having stage 4 disease and CD4 counts <200 were likelier to have dementia as compared to other participants. People with an unknown mode of transmission had higher odds of having AIDS dementia than persons having a mode of transmission as via blood/blood products/invasive procedures/mother-to-child transmission/IV drug abuse. Binomial logistic regression revealed mode of transmission or rather its awareness to be the strongest contributor. CONCLUSIONS: These findings highlight the need for early screening and diagnosis of HIV-associated dementia in patients living with HIV and that of early assessment and initiation of treatment.