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Declining Prevalence of Human Immunodeficiency Virus (HIV)–Associated Neurocognitive Disorders in Recent Years and Associated Factors in a Large Cohort of Antiretroviral Therapy–Treated Individuals With HIV

BACKGROUND: HIV-associated neurocognitive disorders (HAND) have been suggested as persistent even with effective antiretroviral therapy (ART). Aims were to evaluate HAND prevalence and associated factors, in a large cohort of people-with-HIV (PWH). METHODS: ART-treated PWH, underwent a neuropsycholo...

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Autores principales: Mastrorosa, Ilaria, Pinnetti, Carmela, Brita, Anna Clelia, Mondi, Annalisa, Lorenzini, Patrizia, Del Duca, Giulia, Vergori, Alessandra, Mazzotta, Valentina, Gagliardini, Roberta, Camici, Marta, De Zottis, Federico, Fusto, Marisa, Plazzi, Maria Maddalena, Grilli, Elisabetta, Bellagamba, Rita, Cicalini, Stefania, Antinori, Andrea
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9907497/
https://www.ncbi.nlm.nih.gov/pubmed/35982541
http://dx.doi.org/10.1093/cid/ciac658
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author Mastrorosa, Ilaria
Pinnetti, Carmela
Brita, Anna Clelia
Mondi, Annalisa
Lorenzini, Patrizia
Del Duca, Giulia
Vergori, Alessandra
Mazzotta, Valentina
Gagliardini, Roberta
Camici, Marta
De Zottis, Federico
Fusto, Marisa
Plazzi, Maria Maddalena
Grilli, Elisabetta
Bellagamba, Rita
Cicalini, Stefania
Antinori, Andrea
author_facet Mastrorosa, Ilaria
Pinnetti, Carmela
Brita, Anna Clelia
Mondi, Annalisa
Lorenzini, Patrizia
Del Duca, Giulia
Vergori, Alessandra
Mazzotta, Valentina
Gagliardini, Roberta
Camici, Marta
De Zottis, Federico
Fusto, Marisa
Plazzi, Maria Maddalena
Grilli, Elisabetta
Bellagamba, Rita
Cicalini, Stefania
Antinori, Andrea
author_sort Mastrorosa, Ilaria
collection PubMed
description BACKGROUND: HIV-associated neurocognitive disorders (HAND) have been suggested as persistent even with effective antiretroviral therapy (ART). Aims were to evaluate HAND prevalence and associated factors, in a large cohort of people-with-HIV (PWH). METHODS: ART-treated PWH, underwent a neuropsychological examination through a battery of 12 tests exploring 5 different domains, between 2009 and 2020, were included in this cross-sectional analysis. HAND were classified according to Frascati's criteria. Participants were defined as complaining or not-complaining if a cognitive complaint was reported or not. Chi-square for trend and multivariable logistic regression were fitted. RESULTS: Overall, 1424 PWH were enrolled during four three-years periods. HAND prevalence was 24%; among complainers (572/1424), it was 38%, higher than among not-complainers (15%). Over the study period, a decreasing HAND prevalence was found in the entire population (P < 0.001) and in complaining (P < 0.001); in not-complaining it remained stable (P = 0.182). Factors associated with HAND were older age, lower educational level, lower current CD4(+) T-cell count and HCV co-infection. Compared to nonnucleoside reverse transcriptase inhibitors, receiving dual and integrase strand transfer inhibitor (INSTI)-based therapies was associated with a decreased risk of HAND, as well as being tested in more recent years. CONCLUSIONS: In this large cohort of ART-treated PWH, mostly virologically suppressed, a remarkable decreasing HAND prevalence was observed. Besides HIV- and patient-related factors, the reduced risk of HAND found with dual and INSTI-based regimens along with a more recent ART initiation, could suggest a potential role of new treatment strategies in this decline, due to their greater virologic efficacy and better tolerability.
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spelling pubmed-99074972023-02-09 Declining Prevalence of Human Immunodeficiency Virus (HIV)–Associated Neurocognitive Disorders in Recent Years and Associated Factors in a Large Cohort of Antiretroviral Therapy–Treated Individuals With HIV Mastrorosa, Ilaria Pinnetti, Carmela Brita, Anna Clelia Mondi, Annalisa Lorenzini, Patrizia Del Duca, Giulia Vergori, Alessandra Mazzotta, Valentina Gagliardini, Roberta Camici, Marta De Zottis, Federico Fusto, Marisa Plazzi, Maria Maddalena Grilli, Elisabetta Bellagamba, Rita Cicalini, Stefania Antinori, Andrea Clin Infect Dis Major Article BACKGROUND: HIV-associated neurocognitive disorders (HAND) have been suggested as persistent even with effective antiretroviral therapy (ART). Aims were to evaluate HAND prevalence and associated factors, in a large cohort of people-with-HIV (PWH). METHODS: ART-treated PWH, underwent a neuropsychological examination through a battery of 12 tests exploring 5 different domains, between 2009 and 2020, were included in this cross-sectional analysis. HAND were classified according to Frascati's criteria. Participants were defined as complaining or not-complaining if a cognitive complaint was reported or not. Chi-square for trend and multivariable logistic regression were fitted. RESULTS: Overall, 1424 PWH were enrolled during four three-years periods. HAND prevalence was 24%; among complainers (572/1424), it was 38%, higher than among not-complainers (15%). Over the study period, a decreasing HAND prevalence was found in the entire population (P < 0.001) and in complaining (P < 0.001); in not-complaining it remained stable (P = 0.182). Factors associated with HAND were older age, lower educational level, lower current CD4(+) T-cell count and HCV co-infection. Compared to nonnucleoside reverse transcriptase inhibitors, receiving dual and integrase strand transfer inhibitor (INSTI)-based therapies was associated with a decreased risk of HAND, as well as being tested in more recent years. CONCLUSIONS: In this large cohort of ART-treated PWH, mostly virologically suppressed, a remarkable decreasing HAND prevalence was observed. Besides HIV- and patient-related factors, the reduced risk of HAND found with dual and INSTI-based regimens along with a more recent ART initiation, could suggest a potential role of new treatment strategies in this decline, due to their greater virologic efficacy and better tolerability. Oxford University Press 2022-08-19 /pmc/articles/PMC9907497/ /pubmed/35982541 http://dx.doi.org/10.1093/cid/ciac658 Text en © The Author(s) 2022. Published by Oxford University Press on behalf of Infectious Diseases Society of America. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Major Article
Mastrorosa, Ilaria
Pinnetti, Carmela
Brita, Anna Clelia
Mondi, Annalisa
Lorenzini, Patrizia
Del Duca, Giulia
Vergori, Alessandra
Mazzotta, Valentina
Gagliardini, Roberta
Camici, Marta
De Zottis, Federico
Fusto, Marisa
Plazzi, Maria Maddalena
Grilli, Elisabetta
Bellagamba, Rita
Cicalini, Stefania
Antinori, Andrea
Declining Prevalence of Human Immunodeficiency Virus (HIV)–Associated Neurocognitive Disorders in Recent Years and Associated Factors in a Large Cohort of Antiretroviral Therapy–Treated Individuals With HIV
title Declining Prevalence of Human Immunodeficiency Virus (HIV)–Associated Neurocognitive Disorders in Recent Years and Associated Factors in a Large Cohort of Antiretroviral Therapy–Treated Individuals With HIV
title_full Declining Prevalence of Human Immunodeficiency Virus (HIV)–Associated Neurocognitive Disorders in Recent Years and Associated Factors in a Large Cohort of Antiretroviral Therapy–Treated Individuals With HIV
title_fullStr Declining Prevalence of Human Immunodeficiency Virus (HIV)–Associated Neurocognitive Disorders in Recent Years and Associated Factors in a Large Cohort of Antiretroviral Therapy–Treated Individuals With HIV
title_full_unstemmed Declining Prevalence of Human Immunodeficiency Virus (HIV)–Associated Neurocognitive Disorders in Recent Years and Associated Factors in a Large Cohort of Antiretroviral Therapy–Treated Individuals With HIV
title_short Declining Prevalence of Human Immunodeficiency Virus (HIV)–Associated Neurocognitive Disorders in Recent Years and Associated Factors in a Large Cohort of Antiretroviral Therapy–Treated Individuals With HIV
title_sort declining prevalence of human immunodeficiency virus (hiv)–associated neurocognitive disorders in recent years and associated factors in a large cohort of antiretroviral therapy–treated individuals with hiv
topic Major Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9907497/
https://www.ncbi.nlm.nih.gov/pubmed/35982541
http://dx.doi.org/10.1093/cid/ciac658
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