Neurocognitive symptoms and impairment in an HIV community clinic

Background: Neurocognitive impairment is a frequent complication of HIV inf ection and heralds a poor survival prognosis. With the availability of high ly active antiretroviral therapy (HAART), survival times for HIV-infected p atients have markedly increased although the effects of HAART on the preval ence of neurocognitive impairment remain uncertain. Objective: To determine the relationship between self-reported neurocognitive symptoms and neurops ychological (NP) performance together with the impact of HAART among HIV-in fected patients. Methods: A cross-sectional study was performed in which pa tients without previously documented neurocognitive impairment attending an HIV community clinic were questioned about neurocognitive symptoms and a N P test battery was administered. Results: Of the eighty-three patients exam ined, neurocognitive symptoms were reported by 34% of patients and were ass ociated with a shorter duration of HAART and higher viral loads. Patients r eporting neurocognitive symptoms were also more likely to exhibit impaired NP performance (p <0.005) with NP impairment being detected in 46% of all p atients examined (12% with HIV-associated dementia). Neuropsychological imp airment was directly correlated with age (p <0.001), plasma viral load (p < 0.005) and inversely correlated with the number of prescribed antiretrovira l drugs (p <0.01). Conclusions: These results suggest that neurocognitive s ymptoms are predictive of impaired NP performance and that NP impairment re mains a frequent finding among older patients with higher viral loads. An i ncreased number of antiretroviral drugs may be neuroprotective.