Cognitive Assessment of Young Adults Before and After Initiation of Combination Antiretroviral Therapy

Abstract

Objective: In the determination and monitoring of neurocognitive disorders in human immunodeficiency virus (HIV)-positive individuals, there is a need for significantly more practical methods which provide results in a shorter time than the tests that require challenging and specialized expertise. This study aimed to evaluate cognitive functions and the factors affecting them in naïve HIV-positive patients using by Montreal Cognitive Assessment (MoCA) test before and after the initiation of combination antiretroviral therapy.Materials and Methods: HIV-positive, treatment-naïve patients monitored between January-June 2017 were included in the study. The MoCA test was performed at the beginning and the sixth month of the treatment.Results: Forty male patients were included in the study. The mean age was calculated as 29.1±4.0. When the factors affecting the MoCA score were examined, there was a significant relationship between the education level and the MoCA score. Smoking, using alcohol, and substance did not have a significant impact on baseline MoCA values. A significant correlation was found between cluster differentiation 4 (CD4) count and HIV RNA level and attention function. There was a significant increase in the total MoCA score and the MoCA subgroup scores at the end of the sixth month of the treatment. Conclusion:MoCA test is one of the most practical tests that can be applied in a short time period, and it was found useful in evaluating the changes in the cognitive functions of HIVpositive patients during antiretroviral treatment.

Moderate‐to‐severe cognitive impairment is associated with both recent and chronic alcohol misuse in people with HIV: The New Orleans alcohol use in HIV (NOAH) study

“…Previous studies utilizing MoCA to examine the relationship be- and after ART and found no relationship between MoCA scores and alcohol or substance use at baseline (Gül et al, 2022). Importantly, and in contrast to the present study, a history of alcohol or substance abuse was an exclusion criterion for study participation, and the study did not mention what alcohol measure was used to assess alcohol consumption.…”

“…Previous studies utilizing MoCA to examine the relationship between cognitive function and alcohol use in PWH are limited, and this study is the first to examine this relationship in the NOAH cohort. A recent study from Gül and colleagues examined MoCA scores before and after ART and found no relationship between MoCA scores and alcohol or substance use at baseline (Gül et al., 2022). Importantly, and in contrast to the present study, a history of alcohol or substance abuse was an exclusion criterion for study participation, and the study did not mention what alcohol measure was used to assess alcohol consumption.…”

“…Another study in a mixed sex cohort showed that a history of AUD and current heavy drinking affect cognitive performance in PWH and that lifetime AUD and older age appear to be more strongly associated with cognitive impairment relative to the misuse of other drugs of abuse or other clinical factors related to HIV (i.e., viral load and CD4 counts) (Cohen et al, 2018). Still, other studies have shown no association between alcohol use and cognitive dysfunction in PWH (Bourgeois et al, 2020;Gül et al, 2022;Lorkiewicz et al, 2018). Finally, the impact of alcohol misuse on cognitive performance in this population may differ across cognitive domains.…”