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Routine detection and management of neurocognitive impairment in HIV-positive patients in a UK centre

Haddow, LJ; Accoroni, A; Cartledge, JD; Manji, H; Benn, P; Gilson, RJ; (2013) Routine detection and management of neurocognitive impairment in HIV-positive patients in a UK centre. Int J STD AIDS , 24 (3) 217 - 219. 10.1177/0956462412472452. Green open access

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Abstract

We estimated the burden of HIV-associated neurocognitive disorders (HAND) in a UK clinic. From a random sample, and referrals to specialist services over one year (neurology, clinical psychology, hospital admissions), we determined whether patients were diagnosed with HIV-associated dementia (HAD) and whether they reported symptoms suggesting neurocognitive impairment (NCI). In the first sample, 2/150 (prevalence 1.3%; 95% confidence interval [CI] 0.2-4.7%) had documented HAD. Eleven patients (7.3%; CI 3.7-12.7%) reported recent symptoms suggesting NCI; most of these individuals were diagnosed with a psychiatric or substance-use disorder. Among specialist referrals with symptoms suggesting NCI, 11 were diagnosed with HAD from a clinic population of 3129 individuals (annual incidence 0.4%; CI 0.2-0.6%). No patients with mildly symptomatic or asymptomatic HAND were identified in either sample, suggesting that such patients remain undetected in current clinical practice. Evidence-based screening for HAND in HIV clinics may be needed.

Type: Article
Title: Routine detection and management of neurocognitive impairment in HIV-positive patients in a UK centre
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1177/0956462412472452
Publisher version: http://dx.doi.org/10.1177/0956462412472452
Language: English
Additional information: This article is distributed under the terms of the Creative Commons Attribution 3.0 License (http://www.creativecommons.org/licenses/by/3.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (http://www.uk.sagepub.com/aboutus/openaccess.htm).
Keywords: AIDS dementia complex, HIV infection, HIV-associated dementia, HIV-associated neurocognitive disorder, asymptomatic neurocognitive impairment, cross-sectional studies, prevalence, AIDS Dementia Complex, Adult, Aged, Anti-HIV Agents, Cognition Disorders, Cross-Sectional Studies, Female, Great Britain, HIV Infections, Humans, Male, Middle Aged, Neuropsychological Tests, Prevalence, Psychiatric Status Rating Scales, Retrospective Studies, Young Adult
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health > Infection and Population Health
URI: https://discovery.ucl.ac.uk/id/eprint/1404242
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