Investigation of HIV-related neurocognitive disorder areas in HIV-positive patients followed up and treated at İstanbul Medical Faculty

Objectives: In this study, we aimed to investigate HIV-associated neurocognitive disease areas, determination of risk factors and frequency of HIV-positive patients seen in Infectious Diseases and Clinical Microbiology clinic at Istanbul University, Istanbul Faculty of Medicine. Materials and methods: The study was designed as a randomized controlled trial. The study included 91 HIV-positive patients followed in the Infectious Diseases and Clinical Microbiology Outpatient Clinic, confirmed by Western-Blott, and 62 HIV-negative control patients of similar age and education level. Demographic characteristics of the patients, time of diagnosis, lowest and highest CD4+ T lymphocyte counts, lowest and highest HIV RNA copy counts, ART regimen they used, and co-morbidities were recorded. From behavioral scales; Patients who could not obtain a valid score using the " Beck Depression and Beck Anxiety Scale" and the " Daily Activity Using Instrument (IADL)" scale were not included in the study. Then it was evaluated with Neuropsychological Test batteries; MoCA, WCST, SDLT, TMT, CVLT, TOL, and GPT test results were recorded. Then, the Verbal Fluency test was applied to the patients evaluated for language skills, and the result was recorded. Statistical analyzes were performed in the SPSS v25 environment. Statistical significance was assessed by applying Bonferroni correction for the number of multiple comparisons in each neuropsychological test. Results: The prevalence of HAND was 45.1% according to Frascati criteria (ANI 38.5%; MND 5.5% and HAD 1.1%), and 44% according to GDS criteria (ANI 37.4%; MND 5.5% and HAD 1.1%). The prevalence determined by both approaches was quite close to each other. Of the participants in the HAND group, 75.6% had memory, 70.7% language, 68.3% attention and working memory, 46.3% planning skills, 29.3% motor skills, 26.8% information processing speed, and 9.8% conceptualization and executive functions were found to be impaired. General cognition scores, attention, and working memory performance, attention and executive functions performance, planning skills, memory performance, and information processing speed were lower in the HIV-positive patient group compared to controls; it has been shown that semantic fluency skills are partially more inadequate than the control group. There was no difference in motor skills between the HIV-positive patient group and the control group. No correlation was found between neurocognitive dysfunction in HIV-positive patients and the patient's age, gender, and education level. 14 Conclusions: Further examination of patients diagnosed at the asymptomatic stage using neuropsychological test batteries or switching to treatment regimens with high CPE scores and good CNS penetration may be beneficial for patients.