IAS 2015People with HIV who have neurocognitive impairment mild enough not to prompt noticeable symptoms are at increased risk of developing symptomatic impairment, aidsmap reports. Researchers studied neurocognitive problems among 679 adults who completed at least two annual neurophysiological assessments and were participants in the Ontario HIV Treatment Network Cohort Study. Results were presented at the 8th International AIDS Society Conference on HIV Pathogenesis, Treatment and Prevention in Vancouver, British Columbia.

Eighty-three percent of the participants were taking antiretrovirals and 72 percent had a fully suppressed virus. While 45 percent had more than 500 CD4 cells, 58 percent had ever had fewer than 200 CD4s, which has been linked with cognitive impairment.

At their first assessment, 357 participants had normal results on their neuropsychological tests, and 322 (47 percent) had asymptomatic neurocognitive impairment. Twenty-one percent (143) of the participants progressed to symptomatic neurocognitive impairment during a median 34 months.

Twenty-seven percent of those who had asymptomatic impairment at their first assessment progressed to symptomatic impairment, compared with 15 percent of those with initially normal test results. The former group also progressed faster along the scale of cognitive impairment.

Those who had initially asymptomatic impairment were 1.8 times more likely to then develop symptomatic impairment when compared with those who started with normal results. The following factors were also associated with increased likelihood of progression to symptomatic impairment: being female, 1.58 times as likely; depression, 1.87 times as likely; being a current smoker, 1.73 times as likely; and having cardiovascular disease, 1.67 times as likely. Factors that reduced the likelihood of progress included: having more education, 6 percent less likely; having an undetectable viral load, 28 percent less likely; and speaking English at home, 40 percent less likely.

To read the aidsmap article, click here.

To read the conference poster, click here.