Assessment and Management of HIV-Associated Cognitive Impairment: Experience from a Multidisciplinary Memory Service for People Living with HIV
As the HIV population ages, the prevalence of cognitive impairment (CI) is increasing, yet few services exist for the assessment and management of these individuals. Here we provide an initial description of a memory assessment service for people living with HIV and present data from a service evalu...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2019-02-01
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| Series: | Brain Sciences |
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| Online Access: | https://www.mdpi.com/2076-3425/9/2/37 |
| _version_ | 1818942266612383744 |
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| author | Kate Alford Sube Banerjee Eileen Nixon Clara O’Brien Olivia Pounds Andrew Butler Claire Elphick Phillip Henshaw Stuart Anderson Jaime H. Vera |
| author_facet | Kate Alford Sube Banerjee Eileen Nixon Clara O’Brien Olivia Pounds Andrew Butler Claire Elphick Phillip Henshaw Stuart Anderson Jaime H. Vera |
| author_sort | Kate Alford |
| collection | DOAJ |
| description | As the HIV population ages, the prevalence of cognitive impairment (CI) is increasing, yet few services exist for the assessment and management of these individuals. Here we provide an initial description of a memory assessment service for people living with HIV and present data from a service evaluation undertaken in the clinic. We conducted an evaluation of the first 52 patients seen by the clinic. We present patient demographic data, assessment outcomes, diagnoses given and interventions delivered to those seen in the clinic. 41 patients (79%) of those seen in the clinic had objective CI: 16 (31%) met criteria for HIV-associated Neurocognitive Disorder (HAND), 2 (4%) were diagnosed with dementia, 14 (27%) showed CI associated with mental illness and/or drugs/alcohol, 7 (13%) had CI which was attributed to factors other than HIV and in 2 (4%) patients the cause remains unclear. 32 (62%) patients showed some abnormality on Magnetic Resonance Imaging (MRI) brain scans. Patients attending the clinic performed significantly worse than normative scores on all tests of global cognition and executive function. Interventions offered to patients included combination antiretroviral therapy modification, signposting to other services, case management, further health investigations and in-clinic advice. Our experience suggests that the need exists for specialist HIV memory services and that such a model of working can be successfully implemented into HIV patient care. Further work is needed on referral criteria and pathways. Diagnostic processes and treatment offered needs to consider and address the multifactorial aetiology of CI in HIV and this is essential for effective assessment and management. |
| first_indexed | 2024-12-20T07:08:42Z |
| format | Article |
| id | doaj.art-487fe7c335fe4628ae266a3b84983219 |
| institution | Directory Open Access Journal |
| issn | 2076-3425 |
| language | English |
| last_indexed | 2024-12-20T07:08:42Z |
| publishDate | 2019-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Brain Sciences |
| spelling | doaj.art-487fe7c335fe4628ae266a3b849832192022-12-21T19:48:57ZengMDPI AGBrain Sciences2076-34252019-02-01923710.3390/brainsci9020037brainsci9020037Assessment and Management of HIV-Associated Cognitive Impairment: Experience from a Multidisciplinary Memory Service for People Living with HIVKate Alford0Sube Banerjee1Eileen Nixon2Clara O’Brien3Olivia Pounds4Andrew Butler5Claire Elphick6Phillip Henshaw7Stuart Anderson8Jaime H. Vera9Department of Global Health and Infection, Brighton and Sussex Medical School, Brighton BN1 9PX, UKCentre for Dementia Studies, Brighton and Sussex Medical School, Brighton BN1 9PX, UKBrighton and Sussex University Hospitals NHS Trust, Brighton BN2 1ES, UKBrighton and Sussex University Hospitals NHS Trust, Brighton BN2 1ES, UKBrighton and Sussex University Hospitals NHS Trust, Brighton BN2 1ES, UKDepartment of Medicine, Brighton and Sussex Medical School, Brighton BN1 9PX, UKSussex Partnership NHS Foundation Trust, Worthing BN13 3EP, UKSussex Partnership NHS Foundation Trust, Worthing BN13 3EP, UKBrighton and Sussex University Hospitals NHS Trust, Brighton BN2 1ES, UKDepartment of Global Health and Infection, Brighton and Sussex Medical School, Brighton BN1 9PX, UKAs the HIV population ages, the prevalence of cognitive impairment (CI) is increasing, yet few services exist for the assessment and management of these individuals. Here we provide an initial description of a memory assessment service for people living with HIV and present data from a service evaluation undertaken in the clinic. We conducted an evaluation of the first 52 patients seen by the clinic. We present patient demographic data, assessment outcomes, diagnoses given and interventions delivered to those seen in the clinic. 41 patients (79%) of those seen in the clinic had objective CI: 16 (31%) met criteria for HIV-associated Neurocognitive Disorder (HAND), 2 (4%) were diagnosed with dementia, 14 (27%) showed CI associated with mental illness and/or drugs/alcohol, 7 (13%) had CI which was attributed to factors other than HIV and in 2 (4%) patients the cause remains unclear. 32 (62%) patients showed some abnormality on Magnetic Resonance Imaging (MRI) brain scans. Patients attending the clinic performed significantly worse than normative scores on all tests of global cognition and executive function. Interventions offered to patients included combination antiretroviral therapy modification, signposting to other services, case management, further health investigations and in-clinic advice. Our experience suggests that the need exists for specialist HIV memory services and that such a model of working can be successfully implemented into HIV patient care. Further work is needed on referral criteria and pathways. Diagnostic processes and treatment offered needs to consider and address the multifactorial aetiology of CI in HIV and this is essential for effective assessment and management.https://www.mdpi.com/2076-3425/9/2/37HIVHIV-associated neurocognitive disordercognitive impairmentpatient care |
| spellingShingle | Kate Alford Sube Banerjee Eileen Nixon Clara O’Brien Olivia Pounds Andrew Butler Claire Elphick Phillip Henshaw Stuart Anderson Jaime H. Vera Assessment and Management of HIV-Associated Cognitive Impairment: Experience from a Multidisciplinary Memory Service for People Living with HIV Brain Sciences HIV HIV-associated neurocognitive disorder cognitive impairment patient care |
| title | Assessment and Management of HIV-Associated Cognitive Impairment: Experience from a Multidisciplinary Memory Service for People Living with HIV |
| title_full | Assessment and Management of HIV-Associated Cognitive Impairment: Experience from a Multidisciplinary Memory Service for People Living with HIV |
| title_fullStr | Assessment and Management of HIV-Associated Cognitive Impairment: Experience from a Multidisciplinary Memory Service for People Living with HIV |
| title_full_unstemmed | Assessment and Management of HIV-Associated Cognitive Impairment: Experience from a Multidisciplinary Memory Service for People Living with HIV |
| title_short | Assessment and Management of HIV-Associated Cognitive Impairment: Experience from a Multidisciplinary Memory Service for People Living with HIV |
| title_sort | assessment and management of hiv associated cognitive impairment experience from a multidisciplinary memory service for people living with hiv |
| topic | HIV HIV-associated neurocognitive disorder cognitive impairment patient care |
| url | https://www.mdpi.com/2076-3425/9/2/37 |
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