Prevalence and Risk Factors of Dementia in HIV-Infected Patients in the Era of Highly Active Antiretroviral Therapy (HAART)

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Nucharee Kiatsoongsong
Supharat Winitprichagul
Lakkana Boonyagars


Background: Human immunodeficiency virus (HIV) infection is an epidemic worldwide. Despite the combination of antiretroviral therapy to control disease, a higher rate of neurocognitive impairment has been reported. Because highly active antiretroviral therapy (HAART) may not prevent the entry of HIV into the central nervous system, neuronal damage can be affected. Therefore, we conduct the study to evaluate the prevalence and associated factors of HIV-associated neurocognitive disorder.

Methods: We conducted a cross-sectional study in Vajira hospital, a 900-bed university hospital in Bangkok, Thailand. HIV-infected patients who on HAART routinely visit the infectious clinic from August 2019 to March 2021 were included in our study. We collected the MoCA-Thai test and search patient information from the electronic database. Then we analyze the prevalence and factors associated with HIV-associated neurocognitive disorder.

Results: We enrolled 84 patients with HIV infection, (42 men and women). The mean age of our cohort is 63 years (SD, ± 3.9). The duration of HIV infection and duration of current HAART was 13 years (SD, ± 5.7) and 10 years (SD, ± 4.8), respectively. The median CD4 count before HAART was 187 cell/mm3 (IQR, 47.25-323). The median of the CD4 level at the time of enrollment was 507 cell/mm3 (IQR, 319.25-706.25). MoCA scores of less than 26 points were found in 77 (91.7%) patients. Dementia was diagnosed in 13 (15.5%) patients. In adjusted analysis, patients with age equal or more than 65 years were more likely to have dementia than younger patients (OR = 0.14, 95%CI 1.95-26.17: p-value = 0.002) also with years of education less than 9 years (OR = 0.18, 95%CI 1.17-27.38 : p-value = 0.031). Whereas the duration of HIV infection, CD4 level, CPE score, and PI-base regimen were not associated with dementia.

Conclusion: The risk of dementia in HIV patients is significantly higher in older age (equal to or more than 65 years) or years of education less than 9 years.


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