Background. The reported prevalence of HIV-associated neurocognitive disorders in HIVpeople depends on the population studied and the methodology used. We analyze the prevalence of neurocognitive impairment (NCI) and associated factors in patients on successful antiretroviral therapy (ART), without comorbidities. Matherial and methods. Cross-sectional observational study in HIV-subjects, ≥18 yearsold, on stable ART and HIV viral load <50copies/mL. Patients with medical or psychiatric comorbidities and substance abuse were excluded. NCI was diagnosed using Frascati criteria, examining seven neurocognitive domains. We analyzed the association between NCI and: HIV-related clinical variables, carotid intima media thickness, bacterial traslocation, and plasma inflammatory biomarkers (soluble CD14, Interleukin-6 [IL-6], and tumor necrosis factor-α). The prevalence of NCI was calculated with a 95%CI. We fitted a logistic regression model to assess the strength of the associations. Results. Eighty-four patients were included with an observed NCI prevalence of 29.8% (95%CI: 21.0-40.2): 19% had asymptomatic neurocognitive impairment; 8.3%, mild neurocognitive disorder; 2.4%, HIV-associated dementia. Delayed recall was the most commonly affected neurocognitive domain (27.4%). People diagnosed at least 10 years ago (OR:6.5, 95%CI: 1.6-21.7) and those with IL-6 levels above 1.8 pg/mL (OR:6.0, 95%CI 1.1-31.3.3) showed higher odds of NCI in adjusted analyses. Participants with carotid plaques had lower scores for delayed recall: −0.9±1.1 versus −0.2±1.1 (p=0.04). Conclusions. Prevalence of NCI is high in otherwise healthy adults with HIV-infection. In this population, more than 10 years since HIV diagnosis and high IL-6 levels are associated with NCI. Delayed recall neurocognitive domain is worse in patients with subclinical atherosclerosis.
(1) Background: Stress, anxiety, and depression have been identified as factors that influence the development of inflammatory bowel disease (IBD). The main aim of this study was to test the effectiveness of group multicomponent cognitive-behavioral therapy at reducing stress, anxiety, and depression, and improving quality of life and the clinical course of the disease. (2) Methods: A total of 120 patients were evaluated using the General Perceived Stress Scale, Scale of Stress Perceived by the Disease, the anxiety and depression scale, and quality of life questionnaire for patients with IBD. Disease activity was measured using the Mayo Index for ulcerative colitis and CDAI for Crohn's disease, as well as the number of relapses self-reported by patients. Patients were randomized to receive group multicomponent cognitive-behavioral therapy or treatment as usual. (3) Results: The psychological intervention reduced stress (EAE: 45.7 ± 8.8 vs. 40.6 ± 8.4, p = 0.0001; PSS: 28.0 ± 7.3 vs. 25.1 ± 5.9, p = 0.001) and improved quality of life (164.2 ± 34.3 vs. 176.2 ± 28.0, p = 0.001). An improvement was found in the number of relapses self-reported by patients (0.2 relapses/patient vs. control 0.7 relapses/patient; p = 0.027). No differences were found in disease activity indexes. (4) Conclusions: Psychological therapy was associated with improved stress, quality of life and with a decrease in the number of relapses self-reported by patients. Clinical trial registration number: NCT02614014
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