Short Communication: Carotid Intima-Media Thickness Is Not Associated with Neurocognitive Impairment Among People Older than 50 Years With and Without HIV Infection from Thailand

Hiransuthikul, Akarin; Chutinet, Aurauma; Sakulrak, Salila; Samajarn, Jitlada; Vongsayan, Pongpat; Kijpaisalratana, Naruchorn; Akarathanawat, Wasan; Apornpong, Tanakorn; Sangarlangkarn, Aroonsiri; Gatechompol, Sivaporn; Han, Win Min; Chattranukulchai, Pairoj; Kerr, Stephen J.; Ruxrungtham, Kiat; Avihingsanon, Anchalee

doi:10.1089/aid.2019.0139

Cited by 11 publications

(13 citation statements)

References 16 publications

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“…Recently, the MoCA‐T has been increasingly used to identify Thai PWHIV with NCI and is a user‐friendly tool for NCI screening in HIV clinics. The median MoCA score of our study participants was 20.0 (IQR 16.3–23.0), which was lower than the median MoCA score of 24 (IQR 21–26) reported in a previous study in Bangkok [ 12 ]. The frequency of NCI in their cohort of 340 OAHIV (median age of 54.3 years) with good immune status and virologic suppression was 59.4%, which was lower than in our study.…”

Section: Discussioncontrasting

confidence: 89%

“…The prevalence of NCI among PWHIV and non‐HIV older adults in other studies were between 59.4% and 71.4% [ 12 , 21 ]. In our study, the estimated prevalence was 80%.…”

Section: Methodsmentioning

confidence: 99%

“…The internal consistency was demonstrated to have a Cronbach's alpha coefficient of 0.914 [ 13 ]. MoCA‐T has also been used in studies among PWHIV after ART initiation [ 12 , 14 ]. When an assessment was completed, all scores were summed out of a total possible score of 30.…”

Section: Methodsmentioning

confidence: 99%

“…The 2NN study in Thailand in 2008 documented NCI in 37.5% of PWHIV at a median age of 41.2 years who had good virologic control http://onlinelibrary.wiley.com/doi/10.1002/jia2.25983/full | https://doi.org/10.1002/jia2.25983 [11]. More recently, a 2015-2017 study in Bangkok reported an NCI prevalence of 59.4% among PWHIV with a median age of 54.3 years [12]. Factors associated with NCI included increased age, being female, low education, depression and low income [13,14].…”

Section: Introductionmentioning

confidence: 99%

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Neurocognitive performance and quality of life of older adults with HIV on antiretroviral treatment in Northern Thailand

et al. 2022

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Introduction:With virologic suppression and longer life expectancy, older adults with HIV (OAHIV) are at risk for neurocognitive impairment (NCI). This study investigated neurocognitive performance, quality of life (QOL) and the association between OAHIV determinants. Methods: This cross-sectional study was conducted in OAHIV aged ≥ 50 years on antiretroviral treatment at community hospitals in Northern Thailand between September and November 2020. The Montreal Cognitive Assessment Thai Version (MoCA-T) and the Thai-validated Medical Outcomes Study HIV (MOS-HIV) were used. NCI was defined as MoCA-T scores <25: 16-24 for amnestic mild cognitive impairment (aMCI) and <16 for dementia. For QOL, higher scores meant better QOL; a physical health summary T-score ≥50 was defined as good QOL. Results: Overall, 269 OAHIV were enrolled; 59% were female and 99% had virologic suppression. The current median age was 61.8 years (interquartile range [IQR] 58.9-65.7). The median duration of antiretroviral treatment was 10.5 years (IQR 8.5-13.5). The current median CD4 count (234 tested) was 484 cells/mm 3 (IQR 339-634), and 99% had plasma HIV RNA <40 copies/ml (229 tested). The median MoCA-T score was 20.0 (IQR 16.3-23.0). There were 234 OAHIV (87.3%) with NCI: 182 (67.9%) with aMCI and 52 (19.4%) with dementia. A hundred and ninety (70.6%) had good QOL. Bivariate analysis revealed no correlation between MoCA-T scores and QOL. Multivariable linear regression analysis revealed that MoCA-T score was associated with older age (r = -0.144, p = 0.002), lower education (r = 0.629, p < 0.001), lower income (r = 0.797, p = 0.040) and shorter treatment duration (r = 0.189, p = 0.006). Conclusions:The vast majority of OAHIV with virologic suppression had NCI. Approximately two-thirds had a mild impairment and one-fifth had dementia. Neurocognitive performance and QOL were not correlated. Addressing mild NCI would enable more targeted monitoring. Early intervention and support could minimize functional impairment with increased age.

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Section: Discussioncontrasting

confidence: 89%

“…The prevalence of NCI among PWHIV and non‐HIV older adults in other studies were between 59.4% and 71.4% [ 12 , 21 ]. In our study, the estimated prevalence was 80%.…”

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Neurocognitive performance and quality of life of older adults with HIV on antiretroviral treatment in Northern Thailand

et al. 2022

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“…The OALHIV cohort in southern Thailand reported 97.9% virologic suppression in 307 patients at 7.27 years follow-up after ART initiation. (20) Another study in Bangkok, Thailand demonstrated 97.4% virologic suppression in 340 OALHIV at 18.4 years after ART initiation (21).…”

Section: Discussionmentioning

confidence: 99%

Characteristics, clinical outcomes, and mortality of older adults living with HIV receiving antiretroviral treatment in the sub-urban and rural areas of northern Thailand

Aurpibul

Sripan

Paklak

et al. 2022

Preprint

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Since the introduction of antiretroviral treatment (ART), people living with HIV worldwide live into older age. This study described the characteristics, clinical outcomes, and mortality of older adults living with HIV (OALHIV) receiving ART from the National AIDS program in northern Thailand. Participants aged >= 50 years were recruited from the HIV clinics in 12 community hospitals. Data were obtained from medical records and face-to-face interviews. In 2015, 362 OALHIV were enrolled; their median (interquartile range) age and ART duration were 57 years (54-61), and 8.8 years (6.4-11.2), respectively. At study entry, 174 (48.1%) had CD4 counts >= 500 cells/mm 3 ; 357 of 358 (99.6%) with available HIV RNA results were virologic-suppressed. At the year 5 follow-up, 39 died, 11 were transferred to other hospitals, 3 were lost to follow-up, and 40 did not contribute data for this analysis, but remained in care. Among the 269 who appeared, 149 (55%) had CD4 counts >= 500 cells/mm 3 , and 227/229 tested (99%) were virologic-suppressed. The probability of 5-year overall survival (OS) was 89.2% (95% confidence interval, CI 85.4-92.1%). A significantly low 5-year OS (66%) was observed in OALHIV with CD4 counts < 200 cells/mm 3 at study entry. The most common cause of death was organ failures in 11 (28%), followed by malignancies in 8 (21%), infections in 5 (13%), mental health-related conditions in 2 (5%), and unknown in 13 (33%). In OALHIV with stable HIV outcomes, monitoring of organ functions, cancer surveillance, and mental health screening are warranted.

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Trends and Clinical Characteristics of HIV and Cerebrovascular Disease in Low- and Middle-Income Countries (LMICs) Between 1990 and 2021

et al. 2022

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Purpose of the Review To describe trends and clinical characteristics of HIV and cerebrovascular disease between 1990 and 2021 in LMICs and identify the gaps in our understanding. Recent Findings In the era of antiretroviral therapy (ART), people living with HIV (PLWH) live longer and risk excess cerebrovascular events due to ageing and HIV-driven factors. Despite the highest burden of HIV infection in low-to-middle income countries, there is underreporting in the literature of cerebrovascular events in this population. We systematically reviewed published literature for primary clinical studies in adult PLWH and cerebrovascular disease in LMICs. Summary The clinical phenotype of cerebrovascular disease among PLWH over the last three decades in LMICs has evolved and transitioned to an older group with overlapping cerebrovascular risk factors. There is an important need to increase research in this population and standardise reporting to facilitate understanding, guide development of appropriate interventions, and evaluate their impact.

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Short Communication: Carotid Intima-Media Thickness Is Not Associated with Neurocognitive Impairment Among People Older than 50 Years With and Without HIV Infection from Thailand

Cited by 11 publications

References 16 publications

Neurocognitive performance and quality of life of older adults with HIV on antiretroviral treatment in Northern Thailand

Neurocognitive performance and quality of life of older adults with HIV on antiretroviral treatment in Northern Thailand

Characteristics, clinical outcomes, and mortality of older adults living with HIV receiving antiretroviral treatment in the sub-urban and rural areas of northern Thailand

Trends and Clinical Characteristics of HIV and Cerebrovascular Disease in Low- and Middle-Income Countries (LMICs) Between 1990 and 2021

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