Rehabilitation of HIV-associated neurocognitive disorder: a systematic scoping review of available interventions

Abstract

ABSTRACT Objective: Strong healthcare systems require rich rehabilitation protocols for improving the outcomes of disabling ailments such as HIV-associated neurocognitive disorder (HAND). Currently, the rehabilitative interventions for HAND are unknown. We thus reviewed the putative rehabilitative interventions for HAND and evaluated their post-treatment outcomes. Methods: This is a systematic scoping review of articles published in English, between 2009 and 2019. The review was guided by the PRISMA extension for scoping reviews. We searched for articles in PubMed, MEDLINE, Cochrane Library, CINAHL, Academic Search Complete and PsycINFO. Data were selected and extracted according to predesigned eligibility criteria using a standardised data extraction table. We appraised the methodological quality of the included studies using the Mixed Method Appraisal Tool. Results: We identified 423 records, which were screened for eligibility. Twenty two articles were identified, representing a sample of 2795 PLWHIV, who were on average 47 ± 8 years old, with 13 ± 3 years of education. From the reviewed literature, we identified two putative rehabilitative intervention options for HAND, namely cognitive training otherwise known as psycho-cognitive training, and physical activity interventions. All articles reporting on cognitive training for HAND showed improved post-treatment performance, while two of the six interventional physical activity studies recorded improved post-treatment cognitive performance. Discussion: There are limited rehabilitative options available for HAND. Psycho-cognitive training appears to be an effective intervention for HAND, however, the conditions of far-transfer effects need to be set forth. There is insufficient evidence available to support the use of physical activity for HAND thus warranting further research. Registration: The review protocol was registered with Open Science Framework (OSF) registry. The registration DOI:10.17605/OSF.IO/RWQCF.