Poster Abstract Session: HIV Neurocognitive Function
Saturday, October 29, 2016
Room: Poster Hall
Background:Human immunodeficiency virus (HIV) viral load suppression is an important treatment goal and has been associated with decrease in HIV related morbidity and mortality as well as reduced rate of HIV transmission. Identifying patients at risk of virological failure is important to better guide resources to help achieve their treatment goals. Neurocognitive deficits are common in newly diagnosed HIV infected patients and could influence antiretroviral adherence and increase risk of treatment failure. We hypothesized that newly diagnosed HIV infected patients with baseline neurocognitive deficits are at higher risk of virological failure.
Methods:We used the Montreal cognitive assessment (MoCA) score less than 26, which has been previously validated, to identify patients with neurocognitive deficits. HIV viral load suppression was defined as undetectable HIV viral load (less than 48 copies / ml) at one year after entry into care. Logistic regression was performed to determine the association of low baseline MoCA score and failure to achieve viral load suppression at one year.
Results:Among 138 patients enrolled in the study, 54 (39.1%) patients failed to achieve viral load suppression within one year, and 100 (72.5%) patients had baseline MoCA score less than 26. MoCA score less than 26 was significantly associated with a higher risk of virological failure (odds ratio [OR], 3.19; 95% confidence interval [CI], 1.33–7.65). None of the confounding variables were significantly associated with viral load suppression, however variables significantly associated with low MoCA score included higher age (p < 0.01) and presence of depression (p < 0.01). After adjusting for these variables, MoCA score less than 26, was significantly associated with virological failure (OR, 2.7; 95% CI, 1.09–6.69).
Conclusion:Baseline neurocognitive deficit as measured by MoCA was associated with a higher risk of treatment failure. A brief clinical test, such as MoCA can be used to identify patients at risk for treatment failure and could be provided more ancillary support to better achieve viral load suppression.