在艾滋病毒感染者中寻找痴呆:患病率和相关因素

Daniela Pereira Lamas, Simone Barros Tenore, David Salomao Lewi, Paulo Abrao Ferreira
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摘要

人类免疫缺陷病毒(HIV)是导致40岁以上人群神经认知障碍的主要原因。高效抗逆转录病毒疗法(HAART)的发展,对疾病发病机制的理解,以及对HIV感染者更好生活质量的不断追求,导致HIV疾病的慢性演变。因此,hiv相关神经认知障碍(HAND)等慢性疾病的观察已经很普遍。不幸的是,医生对HAND筛查和治疗的不熟悉导致了对病人的不良护理。方法:我们评估了134名艾滋病毒感染者,并进行了两项跟踪测试,一项是评估皮质痴呆的Mini-mental测试,另一项是评估皮质下痴呆的国际HIV痴呆量表。结果:我们在29例患者中观察到与HIV (HAD)相关的痴呆(患病率21.6%;Ci 95%: 15.0 - 29.6)。本研究中与HAD相关的独立因素有:年龄(RPaj 1.05;Ci 1.00 - 1.09;p=0.033), TCD4+最低点(RPaj 0.998;Ci 95% 0.996 - 0.999;p=0.03),两年以上可检测到的HIV病毒载量(RPaj 2.35;Ci 95% 1.27 - 4.33;p = 0.006)。讨论:在我们的研究中,与HIV相关的痴呆患病率与巴西和国际数据相似。早期诊断和治疗是预防HAND发展的基础,特别是在老年患者中。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Pursuing Dementia in People Living with HIV: Prevalence and Associated Factors
Introduction: The human immunodeficiency virus (HIV) is the leading cause of neurocognitive impairment in people over 40. The development of highly active antiretroviral therapy (HAART), the comprehension of disease pathogenesis, and the constant search for better life quality in people living with HIV have led to the HIV disease chronic evolution. Hence, it has been common to observe chronic diseases such as HIV-associated neurocognitive disorder (HAND). Unfortunately, the practitioner’s unfamiliarity with HAND screening and treatment has contributed to poor patient care. Methods: We evaluated 134 patients living with HIV and performed two tracking tests, the Mini-mental, which evaluates cortical dementia, and the International HIV Dementia Scale, which evaluates subcortical dementia. Results: We observed dementia associated with HIV (HAD) in 29 patients (prevalence of 21.6%; CI 95%: 15.0 – 29.6). The independent factors related to HAD in this study, with statistical significance, were age (RPaj 1.05; CI 1.00 – 1.09; p=0.033), TCD4+ nadir (RPaj 0.998; CI 95% 0.996 – 0.999; p=0.03), and more than two years of detectable HIV viral load (RPaj 2.35; CI 95% 1.27 – 4.33; p=0.006). Discussion: The prevalence of dementia related to HIV in our study was similar to the Brazilian and International data. Early diagnosis and treatment are fundamental for preventing HAND development, especially in older patients.
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