Alzheimer Disease and HIV: Untangling the Gordian Knot

2021 ◽  
pp. 10.1212/CPJ.0000000000001102
Author(s):  
Lambros Messinis ◽  
Grigorios Nasios
Keyword(s):  
Future Research ◽  
People Living With Hiv ◽  
Neurocognitive Disorder ◽  
Population Means ◽  
Aged People ◽  
Highly Active ◽  
Hiv Associated Neurocognitive Disorder ◽  
Living With Hiv ◽  
Long Term Survivors

Approximately one decade ago, Brew and Mystique, 1 in their compelling editorial addressed the need for conducting further studies of amyloid metabolism in aged people living with HIV. They also noted the need for future research to provide tools capable of identifying the causes of HIV – Associated Neurocognitive Disorder (HAND) within the context of successful highly active anti-retroviral therapy (HAART). Alisky in 2007, 2 had accurately predicted that successful treatment with HAART in the HIV population means more long term survivors and an aging HIV population vulnerable to develop Alzheimer’s disease (AD).

“I’m Just Forgetting and I Don’t Know Why”: Exploring How People Living With HIV-Associated Neurocognitive Disorder View, Manage, and Obtain Support for Their Cognitive Difficulties

2018 ◽  
Vol 28 (6) ◽  
pp. 859-872 ◽  
Author(s):  
Alexander R. Terpstra ◽  
Catherine Worthington ◽  
Francisco Ibáñez-Carrasco ◽  
Kelly K. O’Brien ◽  
Aiko Yamamoto ◽  
...  
Keyword(s):  
Health Care ◽  
Lived Experience ◽  
Health Care Professionals ◽  
Management Strategies ◽  
Well Being ◽  
People Living With Hiv ◽  
Neurocognitive Disorder ◽  
Cognitive Difficulties ◽  
Hiv Associated Neurocognitive Disorder ◽  
Living With Hiv

HIV-associated neurocognitive disorder (HAND) is common, but the lived experience of HAND is not well-understood. In this descriptive qualitative study, we explored how adults with HAND view, manage, and obtain support for cognitive difficulties. We interviewed 25 participants (20% female; median age = 51 years) who were diagnosed with HAND using neuropsychological assessment and a clinical interview. Semistructured interviews, co-developed with community members living with HIV, focused on how cognitive difficulties manifested and progressed, impacted well-being, and were discussed with others. We analyzed interview transcripts using a team-based, thematic approach. Participants described concentration, memory, and multitasking difficulties that fluctuated over time, as well as potential risk factors, management strategies, and psychosocial consequences. They reported they seldom discussed cognitive impairment with health care professionals, and that receiving a HAND diagnosis was validating, informative, yet somewhat disconcerting. Conversations between health care professionals and people living with HIV about HAND may provide opportunities for education, assessment, and support.

scholarly journals Prevalence and predictors of HIV-associated Neurocognitive Disorder in Ethiopians

2020 ◽  
Author(s):  
Mohammed Salahuddin ◽  
Md Dilshad Manzar ◽  
Hamid Yimam Hassen ◽  
Mihretu Ashuro ◽  
Aleem Unissa ◽  
...  
Keyword(s):  
Risk Factors ◽  
Vulnerable Groups ◽  
Binary Logistic Regression Analysis ◽  
People Living With Hiv ◽  
Neurocognitive Disorder ◽  
Cross Sectional ◽  
Targeted Screening ◽  
Independent Risk Factors ◽  
Hiv Associated Neurocognitive Disorder ◽  
Living With Hiv

Abstract Background Modern antiretroviral therapy has extended the life expectancies of people living with HIV; the prevention and treatment of their associated neurocognitive decline has remained a challenge. Consequently, it is desirable to investigate the prevalence and predictors of HIV-associated Neurocognitive Disorder (HAND) to help in targeted screening and disease prevention. Methods: Two hundred and forty-four people living with HIV were interviewed in a study using a cross-sectional design and International HIV Dementia scale (IHDS). Additionally, the sociodemographic, clinical and psychosocial characteristics of the patients were recorded. Chi-square and binary logistic regression analysis were used to determine the level of significance among the independent risk factors and probable HAND. Results The point prevalence of HAND was found to be 39.3%. Participants’ characteristics of being older than 40 years (AOR = 2.81 (95% CI; 1.11–7.15)), having a history of recreational drug use (AOR = 13.67 (95% CI; 6.42–29.13)), and being non-compliant with prescribed medications (AOR = 2.99 (95% CI; 1.01–8.87)) were independent risk factors for HAND. Conclusion The identification of predictors, some of which may be more closely related to the Ethiopian people living with HIV, may help in targeted screening of vulnerable groups during cART follow-up visits. This may greatly help in strategizing and implementation of the prevention program, more so, because: (i) HAND is an asymptomatic condition for considerable durations, and (ii) clinical trials of HAND therapies have been unsuccessful.

scholarly journals Creating Productive Tensions: Clinicians Working with Patients as Peer Researchers in a Community-Based Participatory Research Study of the Lived Experience of HIV-Associated Neurocognitive Disorder (HAND)

2018 ◽  
Vol 19 (3) ◽  
pp. 53-72
Author(s):  
Francisco Ibáñez-Carrasco ◽  
Alexander Roy Terpstra ◽  
Sean Rourke ◽  
Aiko Yamamoto ◽  
Soo Ying Chan Carusone ◽  
...  
Keyword(s):  
Knowledge Transfer ◽  
Lived Experience ◽  
People Living With Hiv ◽  
Neurocognitive Disorder ◽  
Community Based ◽  
Community Based Research ◽  
Knowledge Transfer And Exchange ◽  
Hiv Associated Neurocognitive Disorder ◽  
Peer Researchers ◽  
Living With Hiv

About 50% of people living with HIV will develop HIV-associated neurocognitive disorder (HAND) during their lifetime, and we know that cognitive issues are a concern for people living with HIV. However, limited information exists regarding how HAND is managed and coped with, or how cognitive issues are discussed with others, including health care professionals. Following a community-based research approach, we conducted 25 interviews in 2016 aimed to (1) build the capacity of people living with HIV, (2) facilitate participant recruitment and data collection, (3) increase the validity and reliability of our data analysis results, and (4) facilitate knowledge transfer and exchange regarding HAND. After thorough training, we engaged a number of peer researchers living with HAND in the analysis and knowledge transfer and exchange (KTE) phases of the study. This engagement prompted a number of tensions between the clinicians and the peers that we learned to navigate and make productive. We conclude that it is possible to engage patients and providers only if careful attention, time and human resources are provided to navigating the emerging tensions. The outcomes of our study suggest that engaging an interdisciplinary team across multiple sites with PRAs is a valuable method for comprehensively exploring the lived experience of a complex chronic condition such as HAND. 

scholarly journals High prevalence of neurocognitive disorders observed among adult people living with HIV/AIDS in Southern Ethiopia: a cross-sectional study

2018 ◽  
Author(s):  
Megbaru Debalkie Animut ◽  
Muluken Bekele Sorrie ◽  
Yinager Workneh ◽  
Manaye yihune Teshale
Keyword(s):  
Associated Factors ◽  
Cross Sectional Study ◽  
Neurocognitive Disorders ◽  
People Living With Hiv ◽  
Neurocognitive Disorder ◽  
Sectional Study ◽  
Cross Sectional ◽  
Hiv Associated Neurocognitive Disorder ◽  
Living With Hiv ◽  
Hiv Aids

AbstractBackgroundComprehensive care given to people living with HIV/AIDS is improving from time to time; however, their concurrent cognitive illness is still ignored, under screened and treated particularly in developing countries. And this problem is also striking in Ethiopia. Therefore, the objective of this study was to assess HIV-associated neurocognitive disorders and associated factors among adult people living with HIV/AIDS.MethodsAn institution based cross sectional study was conducted in Gamo Gofa zone public Hospitals from April to May, 2017. The systematic random sampling technique was used to select a total of 697 people living with HIV/AIDS. Data was collected using structured interviewer administered questionnaire and International HIV Dementia Scale was used to screen HIV-associated neurocognitive deficits. Data was entered using Epidata version 3.1 and analyzed using SPSS version 20. Both bivariable and multivariable logistic regression analyses were performed to identify associated factors. A P value 0.05 with 95% confidence level was used to declare statistical significance.ResultA total of 684 study participants were included with a 98 % response rate. From the total participants, 56% were females while 44% were males. The mean (±SD) age of the participants was 38.8±8.8years.The prevalence of HIV-associated neurocognitive disorder was 67.1% (95%CI; 63.6, 70.5). The multivariable logistic analysis indicated that body mass index 16 kg/m2 (AOR 4.149 (1.512-11.387)), being married (AOR 0.9 (0.604-0.623), unemployment (AOR 5.930 (3.013-11.670) and being in WHO clinical stage T3 category (AOR 2.870 (1.098-7.500) were the key predictors of HIV-associated neurocognitive disorders among people living with HIV/AIDS.ConclusionIn this study the prevalence of HIV-associated neurocognitive disorder is higher than the earlier reports in Ethiopia and Africa. The associated factors also vary from that of earlier studies. This indicates the need for formulating preventive mental health programs and policies for people living with HIV/AIDS.

scholarly journals Scaling Up Information Sharing on HIV-Associated Neurocognitive Disorder: Raising Awareness and Knowledge Among Key Stakeholders

SAGE Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 215824402110168
Author(s):  
Renato M. Liboro ◽  
Paul A. Shuper ◽  
Lori E. Ross
Keyword(s):  
Health Care ◽  
Information Sharing ◽  
Service Providers ◽  
Scale Up ◽  
People Living With Hiv ◽  
Neurocognitive Disorder ◽  
Public Health Informatics ◽  
Raising Awareness ◽  
Hiv Associated Neurocognitive Disorder ◽  
Hiv Aids

Although the majority of specialists and researchers in the field of HIV/AIDS are aware and knowledgeable about HIV-associated neurocognitive disorder (HAND) as a condition that affects as much as 50% of people living with HIV/AIDS (PLWH), research has documented that many health care and service providers who work directly with PLWH are either unaware of HAND or believe they do not know enough information about HAND to effectively support their clients experiencing neurocognitive challenges. Based on the findings of a qualitative study that interviewed 33 health care and service providers in HIV/AIDS services to identify and examine their awareness and knowledge on HAND, this article argues for utilizing a combination of Public Health Informatics principles; communication techniques, propagation strategies, and recognized approaches from Implementation and Dissemination Science; and social media and online discussion platforms, in addition to traditional Knowledge Mobilization strategies, to scale up information sharing on HAND among all relevant stakeholders. Increasing information sharing among stakeholders would be an important step to raising awareness and knowledge on HAND, and consequently, improving care, services, and support for PLWH and neurocognitive issues.

Sign in / Sign up

Export Citation Format

Share Document