Aging, neurocognitive impairment and adherence to antiretroviral therapy in human immunodeficiency virus-infected individuals
Background/objective: There is an increasing number of older patients with human immunodeficiency virus infection due to the success of antiretroviral therapy, the improved prognosis and life expectancy of patients, and the higher number of new infections among older individuals. The main objective...
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doaj-cd68ad3936e941c7b0880b54619bf6f72020-11-25T03:02:17ZengElsevierBrazilian Journal of Infectious Diseases1413-86702016-11-01206599604S1413-86702016000600599Aging, neurocognitive impairment and adherence to antiretroviral therapy in human immunodeficiency virus-infected individualsCezar Arthur Tavares Pinheiro0Luciano Dias de Mattos Souza1Janaína Vieira dos Santos Motta2Evelin Franco Kelbert3Clarissa de Souza Ribeiro Martins4Marília Silva de Souza5Karen Amaral Tavares Pinheiro6Fábio Monteiro da Cunha Coelho7Ricardo Tavares Pinheiro8Universidade Federal de Pelotas, Faculdade de Medicina, Serviço de Asssitência Especializada em HIV AIDS, Pelotas, RS, Brazil; Universidade Católica de Pelotas, Programa de Pós-Graduação em Saúde e Comportamento, Pelotas, RS, Brazil; Corresponding author.Universidade Católica de Pelotas, Programa de Pós-Graduação em Saúde e Comportamento, Pelotas, RS, BrazilUniversidade Católica de Pelotas, Programa de Pós-Graduação em Saúde e Comportamento, Pelotas, RS, BrazilUniversidade Católica de Pelotas, Programa de Pós-Graduação em Saúde e Comportamento, Pelotas, RS, BrazilUniversidade Católica de Pelotas, Programa de Pós-Graduação em Saúde e Comportamento, Pelotas, RS, BrazilUniversidade Católica de Pelotas, Programa de Pós-Graduação em Saúde e Comportamento, Pelotas, RS, BrazilUniversidade Católica de Pelotas, Programa de Pós-Graduação em Saúde e Comportamento, Pelotas, RS, BrazilUniversidade Católica de Pelotas, Programa de Pós-Graduação em Saúde e Comportamento, Pelotas, RS, BrazilUniversidade Católica de Pelotas, Programa de Pós-Graduação em Saúde e Comportamento, Pelotas, RS, BrazilBackground/objective: There is an increasing number of older patients with human immunodeficiency virus infection due to the success of antiretroviral therapy, the improved prognosis and life expectancy of patients, and the higher number of new infections among older individuals. The main objective of the present study was to compare the characteristics of older human immunodeficiency virus patients with those of younger patients. Materials and methods: We conducted a cross-sectional study with human immunodeficiency virus-infected patients who were treated at the Specialized Care Service (Serviço de Assistência Especializada) for human immunodeficiency virus/AIDS in the city of Pelotas, South Brazil. Sociodemographic information as well as data on human immunodeficiency virus infection and treatment were collected. All participants underwent psychiatric and neurocognitive assessments, and their adherence to antiretroviral therapy was evaluated. Results: A total of 392 patients participated in the study, with 114 patients aged 50 years and older. The characteristics showing significant differences between older and younger human immunodeficiency virus-infected patients included race/ethnicity, comorbidities, duration and adherence to antiretroviral therapy, currently undetectable viral load, and cognitive impairment. Compared to younger patients, older patients were at higher risk of exhibiting cognitive impairment [OR 2.28 (95% CI: 1.35–3.82, p = 0.002)] and of having increased adherence to antiretroviral therapy [OR 3.11 (95% CI: 1.67–5.79, p < 0.001)]. Conclusions: The prevalence of neurocognitive impairment remained high in human immunodeficiency virus-infected patients despite antiretroviral therapy. In the present study, the prevalence of this type of impairment was significantly higher in patients aged ≥50 years, most likely due to aging, human immunodeficiency virus infection, and a possible synergistic effect between these factors. Despite this higher prevalence, older patients exhibited higher rates of adherence to antiretroviral therapy and of undetectable human immunodeficiency virus viral load. Keywords: Aging, HIV, Neurocognitive impairment, Adherencehttp://www.sciencedirect.com/science/article/pii/S1413867016303853 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Cezar Arthur Tavares Pinheiro Luciano Dias de Mattos Souza Janaína Vieira dos Santos Motta Evelin Franco Kelbert Clarissa de Souza Ribeiro Martins Marília Silva de Souza Karen Amaral Tavares Pinheiro Fábio Monteiro da Cunha Coelho Ricardo Tavares Pinheiro |
spellingShingle |
Cezar Arthur Tavares Pinheiro Luciano Dias de Mattos Souza Janaína Vieira dos Santos Motta Evelin Franco Kelbert Clarissa de Souza Ribeiro Martins Marília Silva de Souza Karen Amaral Tavares Pinheiro Fábio Monteiro da Cunha Coelho Ricardo Tavares Pinheiro Aging, neurocognitive impairment and adherence to antiretroviral therapy in human immunodeficiency virus-infected individuals Brazilian Journal of Infectious Diseases |
author_facet |
Cezar Arthur Tavares Pinheiro Luciano Dias de Mattos Souza Janaína Vieira dos Santos Motta Evelin Franco Kelbert Clarissa de Souza Ribeiro Martins Marília Silva de Souza Karen Amaral Tavares Pinheiro Fábio Monteiro da Cunha Coelho Ricardo Tavares Pinheiro |
author_sort |
Cezar Arthur Tavares Pinheiro |
title |
Aging, neurocognitive impairment and adherence to antiretroviral therapy in human immunodeficiency virus-infected individuals |
title_short |
Aging, neurocognitive impairment and adherence to antiretroviral therapy in human immunodeficiency virus-infected individuals |
title_full |
Aging, neurocognitive impairment and adherence to antiretroviral therapy in human immunodeficiency virus-infected individuals |
title_fullStr |
Aging, neurocognitive impairment and adherence to antiretroviral therapy in human immunodeficiency virus-infected individuals |
title_full_unstemmed |
Aging, neurocognitive impairment and adherence to antiretroviral therapy in human immunodeficiency virus-infected individuals |
title_sort |
aging, neurocognitive impairment and adherence to antiretroviral therapy in human immunodeficiency virus-infected individuals |
publisher |
Elsevier |
series |
Brazilian Journal of Infectious Diseases |
issn |
1413-8670 |
publishDate |
2016-11-01 |
description |
Background/objective: There is an increasing number of older patients with human immunodeficiency virus infection due to the success of antiretroviral therapy, the improved prognosis and life expectancy of patients, and the higher number of new infections among older individuals. The main objective of the present study was to compare the characteristics of older human immunodeficiency virus patients with those of younger patients. Materials and methods: We conducted a cross-sectional study with human immunodeficiency virus-infected patients who were treated at the Specialized Care Service (Serviço de Assistência Especializada) for human immunodeficiency virus/AIDS in the city of Pelotas, South Brazil. Sociodemographic information as well as data on human immunodeficiency virus infection and treatment were collected. All participants underwent psychiatric and neurocognitive assessments, and their adherence to antiretroviral therapy was evaluated. Results: A total of 392 patients participated in the study, with 114 patients aged 50 years and older. The characteristics showing significant differences between older and younger human immunodeficiency virus-infected patients included race/ethnicity, comorbidities, duration and adherence to antiretroviral therapy, currently undetectable viral load, and cognitive impairment. Compared to younger patients, older patients were at higher risk of exhibiting cognitive impairment [OR 2.28 (95% CI: 1.35–3.82, p = 0.002)] and of having increased adherence to antiretroviral therapy [OR 3.11 (95% CI: 1.67–5.79, p < 0.001)]. Conclusions: The prevalence of neurocognitive impairment remained high in human immunodeficiency virus-infected patients despite antiretroviral therapy. In the present study, the prevalence of this type of impairment was significantly higher in patients aged ≥50 years, most likely due to aging, human immunodeficiency virus infection, and a possible synergistic effect between these factors. Despite this higher prevalence, older patients exhibited higher rates of adherence to antiretroviral therapy and of undetectable human immunodeficiency virus viral load. Keywords: Aging, HIV, Neurocognitive impairment, Adherence |
url |
http://www.sciencedirect.com/science/article/pii/S1413867016303853 |
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