327. Neurocognitive Function in an HIV-Infected Population in a Community Health Center Network
Session: Poster Abstract Session: HIV Co-morbidities
Thursday, October 3, 2013
Room: The Moscone Center: Poster Hall C
Posters
  • 327_IDWPoster.pdf (1.7 MB)
  • Background: It is estimated that approximately 50% of HIV-positive individuals suffer from HIV-associated neurocognitive disorders (HAND). HAND prevalence within community health centers is not well understood and a comprehensive understanding of the prevalence of cognitive impairment in this population is needed.

    Methods: A validated cognitive assessment tool was administered during routine medical visits for HIV-infected individuals at 3 community health centers. Results were evaluated according to a normalized scale and correlated with demographic and virologic markers. 

    Results: Community health center patients (n=82) showed extremely high levels of cognitive impairment (76.8% of patients, n=63). Patient age ranged from 21 to 73 years with an average age of 47. The average CD4+ count was 580.  Eighty-eight percent of patients were on HAART; 82 percent of patients had viral load <200 copies/mL. Neurological impairment was found to be slightly less common in patients with a viral load (VL) <200 copies/mL (76.1%, n = 66) than in patients with a VL ≥200 copies/mL (78.6%, n = 16). Patients with a history of AIDS (n = 18) also had a marginally higher rate of cognitive impairment (77.8 %) than those in the non-AIDS group (76.5%, n =64). A greater disparity was evident when considering more marked cognitive impairment (scores 2 standard deviations below normal), which was about 50% more prevalent in the AIDS group than the non-AIDS group.

    Conclusion: Despite suppressed viral loads and high CD4+ counts, neurological dysfunction was considerably higher in our population (76.8%) than was expected from previously published reports (50%). Patients with a history of AIDS by CD4+ counts were particularly at risk for more marked impairment. Cognitive assessments require few extra resources, are easy to administer, and are well received by patients. Assessments can be done by non-clinical personnel in 10-15 minutes and were often completed while patients waited to see their providers. Given the high levels of cognitive impairment in this population and the relative ease of assessment, we recommend continued aggressive screening and linkage to follow-up care for patients in this setting.

    Lacey Gleason, Justin D'addario and Christine Kerr, MD, Hudson River HealthCare, Peekskill, NY

    Disclosures:

    L. Gleason, None

    J. D'addario, None

    C. Kerr, None

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