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Assessment and management of HIV-associated cognitive impairment: experience from a multidisciplinary memory service for people living with HIV

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posted on 2023-06-09, 16:52 authored by Katie AlfordKatie Alford, Sube Banerjee, Eileen Nixon, Clara O’Brien, Olivia Pounds, Andrew Butler, Claire Elphick, Phillip Henshaw, Stuart Anderson, Jaime Vera RojasJaime Vera Rojas
As the HIV population ages, the prevalence of cognitive impairment (CI) is increasing, yet few services exist for the assessment and management of these individuals. Here we provide an initial description of a memory assessment service for people living with HIV and present data from a service evaluation undertaken in the clinic. We conducted an evaluation of the first 52 patients seen by the clinic. We present patient demographic data, assessment outcomes, diagnoses given and interventions delivered to those seen in the clinic. 41 patients (79%) of those seen in the clinic had objective CI: 16 (31%) met criteria for HIV-associated Neurocognitive Disorder (HAND), 2 (4%) were diagnosed with dementia, 14 (27%) showed CI associated with mental illness and/or drugs/alcohol, 7 (13%) had CI which was attributed to factors other than HIV and in 2 (4%) patients the cause remains unclear. 32 (62%) patients showed some abnormality on Magnetic Resonance Imaging (MRI) brain scans. Patients attending the clinic performed significantly worse than normative scores on all tests of global cognition and executive function. Interventions offered to patients included combination antiretroviral therapy modification, signposting to other services, case management, further health investigations and in-clinic advice. Our experience suggests that the need exists for specialist HIV memory services and that such a model of working can be successfully implemented into HIV patient care. Further work is needed on referral criteria and pathways. Diagnostic processes and treatment offered needs to consider and address the multifactorial aetiology of CI in HIV and this is essential for effective assessment and management.

History

Publication status

  • Published

File Version

  • Published version

Journal

Brain Sciences

ISSN

2076-3425

Publisher

MDPI

Issue

2

Volume

9

Page range

37 1-12

Department affiliated with

  • Global Health and Infection Publications

Full text available

  • Yes

Peer reviewed?

  • Yes

Legacy Posted Date

2019-02-13

First Open Access (FOA) Date

2019-02-13

First Compliant Deposit (FCD) Date

2019-02-13

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