Neurocognitive course at 2-year follow-up in a Swiss cohort of people with well-treated HIV

Publication

Neurocognitive course at 2-year follow-up in a Swiss cohort of people with well-treated HIV

Journal Paper/Review - Dec 1, 2021

Damas José, Hundsberger Thomas, Di Benedetto Caroline, Rossi Stefania, Hasse Barbara, Schlosser Ladina, Du Pasquier Renaud, Darling Katharine E A, Cavassini Matthias, Schmid Patrick, Assal Frédéric, Ledergerber Bruno, Nadin Isaure, Tarr Philip E, Stoeckle Marcel, Kunze Ursi, Hauser Christoph, Gutbrod Klemens, Calmy Alexandra, and the NAMACO study group

Citation

Damas J, Hundsberger T, Di Benedetto C, Rossi S, Hasse B, Schlosser L, Du Pasquier R, Darling K, Cavassini M, Schmid P, Assal F, Ledergerber B, Nadin I, Tarr P, Stoeckle M, Kunze U, Hauser C, Gutbrod K, Calmy A, and the NAMACO study group. Neurocognitive course at 2-year follow-up in a Swiss cohort of people with well-treated HIV. AIDS 2021; 35:2469-2480.

Type

Journal Paper/Review (English)

Journal

AIDS 2021; 35

Publication Date

Dec 1, 2021

Issn Electronic

1473-5571

Pages

2469-2480

Brief description/objective

OBJECTIVE
The aim of this study was to examine neurocognitive course over time among people with well treated HIV.

DESIGN
The Neurocognitive Assessment in the Metabolic and Aging Cohort (NAMACO) study is an ongoing, prospective, longitudinal, multicenter and multilingual study within the Swiss HIV Cohort Study (SHCS). Participants undergo neuropsychological assessment at baseline and two-yearly follow-up.

SETTING
Seven SHCS centres.

PARTICIPANTS
Patients aged at least 45 years enrolled in the SHCS with fluency in the local language (French, German or Italian) and agreeing to participate in the NAMACO study: 981 participants at baseline, 720 at 2-year follow-up of whom 644 had complete data sets.

INTERVENTION
Standardized neuropsychological assessment at baseline and 2-year follow-up.

MAIN OUTCOME MEASURE
Neurocognitive performance using Frascati criteria and mean z-scores.

RESULTS
Four participants (of 644, 0.6%) had plasma HIV-1 RNA more than 50 copies/ml; median CD4+ cell count was 660 cells/μl. According to Frascati criteria, 204 participants (31.7%) had neurocognitive impairment (NCI) at baseline. NCI severity in these participants changed little over 2 years and comprehensive models based on Frascati criteria were not feasible. Examining mean z-scores, however, we observed neurocognitive stability or improvement over two years in five of seven neurocognitive domains assessed. Age at least 65 years (P = 0.02) and cognitive complaints (P = 0.004) were associated with neurocognitive decline, while black race (P = 0.01) and dolutegravir treatment (P = 0.002) were associated with improvement.

CONCLUSION
Frascati criteria were less sensitive in measuring NCI change and therefore unsuitable for following neurocognitive course in our cohort of people with well treated HIV. Examining neurocognitive course by mean z-score change, we observed stability or improvement.