Prevalence, Demographic Correlates, and Medical Correlates of Cognitive Impairment Among Iranian People Living With HIV: A Cross-sectional Survey Study

Abstract

While taking antiretroviral therapy, 30%–60% of people living with HIV (PLWH) experience neurocognitive impairment (NCI). To determine NCI prevalence among Iranian PLWH, by the computerized Vienna Test System, 63 adults living without HIV and 63 Iranian PLWH aged 18–50 years (M = 35.3, SD = 7.9) were assessed for cognitive function. NCI was determined by receiver operating characteristic curve cutoff points based on the adults living without HIV. Associations between demographics, HIV serostatus markers, and mean T-scores were investigated. Performance differences were tested by including significant covariates in an analysis of covariance. NCI prevalence rates were 57.14% in PLWH and 19.05% in adults living without HIV. Global neurocognitive performance and all cognitive domains were significantly different between the groups, except for visual memory and selective attention. In Iran, NCI prevalence parallels that reported in PLWH worldwide. There should be a strategy to screen Iranian PLWH for NCI.

Immediate and Long-Term Effects of a Computerized Cognitive Rehabilitation Therapy on Cognitive Function in People Living with HIV in Iran: A Single-Blind Two-Arm Parallel Randomized Controlled Trial

“…In this study, the mean RT scores of the participants toward all three kinds of stimuli were averaged to one total score, which was used as the spatial attention (vigilance) score. The cut-off point provided for PWH for this test is 35.33 (Etesami et al, 2022). Depending on test form, reliability was between r = 0.88 and r = 0.97 and Cronbach α values were >0.9 (Sturm, 2011b).…”

“…The main score is planning ability, the number of items done correctly within 1 min. The ones with scores below 34 were considered impaired and included in the intervention (Etesami et al, 2022). Cronbach a and measures of reliability for planning ability are .0.7 (Tower of London, Freiburg; Kaller et al, 2016) Visual memory.…”

“…Based on these CCRT studies in PWH with NCI, the objective of this study was to investigate whether CCRT can improve cognition by comparing cognitive performance of two groups of PWH who are on cART, one receiving CCRT sessions and the other receiving a treatment-as-usual (TAU) protocol. In this study, due to previous findings that showed certain cognitive domains may be more impaired among an Iranian sample (Etesami et al, 2022), the impact of the CCRT protocol was studied on specific cognitive domains of nonverbal learning, planning, divided attention, spatial attention (vigilance), selective attention, and visual memory, as well as a global neurocognitive performance score. Based on previous CCRT studies (i.e., Vance, Blake, et al, 2019), it was hypothesized that compared with the TAU group, those who received the CCRT training would experience enhanced nonverbal learning, planning performance, visual memory, attention (including divided, spatial and selective attention) and improved global neurocognitive performance.…”

“…Etesami et al (2022) used the computerized Vienna Test System (VTS) to examine the prevalence of NCI among virally suppressed PWH in Iran. Using local cognitive norms, their study demonstrated that 57.4% of PWH on cART therapy had NCI, compared with 19.1% in a control group of persons without HIV.…”

False memory, attentional bias and future thinking among people living with HIV with posttraumatic stress disorder

“…Cognitive problems are common among PLWH. Etesami et al (2022) recently examined cognitive impairments among Iranian PLWH. They found that cognitive impairment prevalence rates were 57.14% among PLWH, which is comparable to other studies conducted in LMICs.…”