SAN DIEGO — Physicians at a university-based infectious disease clinic are not routinely screening for HIV-associated neurocognitive impairment in patients infected with HIV, results from a small, single-center study has shown.
“Although the incidence of HIV neurocognitive impairment per year is decreasing, it's still very prevalent,” Dr. Kristin M. Brousseau said in an interview during a poster session at the annual meeting of the American Neuropsychiatric Association. Cognitive impairment has significant implications for patients' ability to adhere to their medications, she noted.
She and her associates randomly reviewed the charts of 50 HIV-positive patients who visited a university-based infectious disease clinic. They used 15 search terms to identify whether physicians recorded HIV-associated neurocognitive impairment (HNCI) as a clinical problem.
The mean age of the 50 patients was 45 years, and most (78%) were male, said Dr. Brousseau, of the department of psychiatry at the University of Colorado at Denver and Health Sciences Center. More than half (56%) had a coexisting psychiatric diagnosis, and 48% had a coexisting substance abuse diagnosis.
HNCI was documented in the medical records of only three patients (6%), even though the reported prevalence in the medical literature is 30%–40%. Only one patient underwent formal cognitive screening.
Physicians are “not doing a screening test for cognition,” which can be performed in 5–7 minutes, she said.
The researchers noted that hepatitis C coinfection and a history of interferon treatment were seen in the patients with documented HNCI.
“Further studies are needed to determine the true prevalence of HNCI and explore the long-term effects of HCV coinfection and interferon treatment in this population,” they wrote in their poster.
Doug Brunk
Cognitive impairment has significant implications for patients' abilityto adhere to their medications. DR. BROUSSEAU