HIV-associated neurocognitive dysfunction in the Chugoku-Shikoku region of Japan: A cross-sectional study

IF 1.9 4区医学 Q3 INFECTIOUS DISEASES

Journal of Infection and Chemotherapy Pub Date : 2025-07-04 DOI:10.1016/j.jiac.2025.102768

Hisafumi Kihara , Aya Nakao , Tatsuya Konishi , Jun Yamanouchi , Takumi Nishida , Miho Nakamura , Seisho Takeuchi , Yutaka Sato , Yumi Akamatsu , Hidetoshi Tani , Hideho Wada , Emi Tokui , Michiko Kawata , Takashi Kaimen , Shuji Ozaki , Chie Iketani , Kentaro Kawabe , Kiyonori Takada

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引用次数: 0

Abstract

Introduction

Although combination antiretroviral therapy (cART) is widely used, HIV-associated neurocognitive disorder (HAND) remains a significant challenge for people living with HIV. This study aimed to investigate the characteristics of HAND among HIV patients in the Chugoku-Shikoku region of Japan using the CoCoBattery, a unified neurocognitive test employed in a nationwide multicenter prospective cross-sectional study on HAND.

Methods

A cross-sectional study was conducted in seven general hospitals from January 2019 to March 2023, including 103 HIV patients. HAND was classified into HIV-associated dementia (HAD), mild neurocognitive disorder (MND), and asymptomatic neurocognitive impairment (ANI, asymptomatic HAND) based on the Frascati criteria. Multivariable logistic regression analysis was performed to identify factors associated with HAND and asymptomatic HAND.

Results

Among the 103 patients, 62 (60.2 %) were diagnosed with HAND, including 11 (10.7 %) with HAD, 16 (15.5 %) with MND, and 35 (34.0 %) with ANI. No significant differences in baseline characteristics were observed between the HAND and non-HAND groups. However, a positive association was observed between an HIV-RNA copy number ≥200 copies/mL and asymptomatic HAND (adjusted odds ratio (OR): 11.15; 95 % confidence interval (CI): 1.13–297.17). Notably, 10 ANI patients exhibited neurocognitive impairment equivalent to HAD.

Conclusions

ANI accounted for a large proportion of HAND cases and included patients with significant neurocognitive impairment. Elevated HIV-RNA copy numbers were associated with ANI, highlighting the need for careful monitoring and support for these patients, even in the absence of subjective symptoms.

查看原文本刊更多论文

hiv相关的神经认知功能障碍在日本四国地区：一项横断面研究。

导语：尽管抗逆转录病毒联合治疗（cART）被广泛使用，但HIV相关神经认知障碍（HAND）仍然是HIV感染者面临的一个重大挑战。本研究旨在使用CoCoBattery（一种统一的神经认知测试，用于全国多中心前瞻性横断面HAND研究）来调查日本chugoku -四国地区HIV患者的HAND特征。方法：2019年1月至2023年3月在7家综合医院进行横断面研究，包括103例HIV患者。根据Frascati标准，HAND被分为hiv相关痴呆（HAD）、轻度神经认知障碍（MND）和无症状神经认知障碍（ANI，无症状HAND）。进行多变量logistic回归分析以确定与HAND和无症状HAND相关的因素。结果：103例患者中，确诊HAND 62例（60.2%），其中HAD 11例（10.7%），MND 16例（15.5%），ANI 35例（34.0%）。在HAND组和非HAND组之间，基线特征没有显著差异。然而，在HIV-RNA拷贝数≥200拷贝/mL和无症状HAND之间观察到正相关(调整优势比（OR）： 11.15；95%置信区间（CI）： 1.13-297.17)。值得注意的是，10例ANI患者表现出相当于HAD的神经认知障碍。结论：ANI在HAND病例中占很大比例，包括有明显神经认知障碍的患者。HIV-RNA拷贝数升高与ANI相关，强调了对这些患者进行仔细监测和支持的必要性，即使在没有主观症状的情况下。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Infection and Chemotherapy INFECTIOUS DISEASES-PHARMACOLOGY & PHARMACY

CiteScore

4.10

自引率

4.50%

发文量

303

审稿时长

47 days

期刊介绍： The Journal of Infection and Chemotherapy (JIC) — official journal of the Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases — welcomes original papers, laboratory or clinical, as well as case reports, notes, committee reports, surveillance and guidelines from all parts of the world on all aspects of chemotherapy, covering the pathogenesis, diagnosis, treatment, and control of infection, including treatment with anticancer drugs. Experimental studies on animal models and pharmacokinetics, and reports on epidemiology and clinical trials are particularly welcome.