Prevalence of HIV-associated neurocognitive disorders in the Multicenter AIDS Cohort Study
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OBJECTIVE: To evaluate the frequency of HIV-associated neurocognitive disorder (HAND) in HIV+ individuals and determine whether the frequency of HAND changed over 4 years of follow-up. METHODS: The Multicenter AIDS Cohort Study (MACS) is a prospective study of gay/bisexual men. Beginning in 2007, all MACS participants received a full neuropsychological test battery and functional assessments every 2 years to allow for HAND classification. RESULTS: The frequency of HAND for the 364 HIV+ individuals seen in 2007-2008 was 33% and for the 197 HIV+ individuals seen at all time periods during the 2007-2008, 2009-2010, and 2011-2012 periods were 25%, 25%, and 31%, respectively. The overall frequency of HAND increased from 2009-2010 to 2011-2012 (p = 0.048). Over the 4-year study, 77% of the 197 HIV+ individuals remained at their same stage, with 13% showing deterioration and 10% showing improvement in HAND stage. Hypercholesterolemia was associated with HAND progression. A diagnosis of asymptomatic neurocognitive impairment was associated with a 2-fold increased risk of symptomatic HAND compared to a diagnosis of normal cognition. CONCLUSION: HAND remains common in HIV+ individuals. However, for the majority of HIV+ individuals on combination antiretroviral therapy with systemic virologic suppression, the diagnosis of HAND is not a progressive condition over 4 years of follow-up. Future studies should evaluate longitudinal changes in HAND and specific neurocognitive domains over a longer time period.
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Many HIV-1-positive individuals today still develop HIV-1-associated dementia despite improved prognosis with anti-retroviral therapy.
“Human immunodeficiency virus (HIV)-1 prognosis greatly improved with the era of anti-retroviral therapy; however, many HIV-1-positive individuals today still develop HIV1-associated dementia (HAD) (292, 511).”
From Blood-Brain Barrier: From Physiology to Disease and Back (2019) · cites this paper as [511]
The Results report HAD in 5% of 364 HIV-positive participants in 2007–2008, showing that it persisted in the antiretroviral-therapy era. But the study measures prevalence, not how many people develop dementia, and 5% does not substantiate the claim’s emphasis on “many.” The Abstract also says HAD had become dramatically less frequent. (LLM, conf=0.86)
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- Authors
- Sacktor, N., Skolasky, R. L., Seaberg, E., Munro, C., Becker, J. T., Martin, E., Ragin, A., Levine, A., & Miller, E.
- Affiliations
- Northwestern University (US)
- ORCID
- Venue
- Neurology
- Published
- 2016-01-26
- Volume
- 86
- Issue
- 4
- Pages
- 334-340
- ISSN
- 0028-3878 (ISSN-L)
- 1526-632X
- PMC
- PMC4776086
- OpenAlex
- W2342035923
- Cited by
- 383
- References
- 3
- Citations by year
- 2026: 18 · 2025: 30 · 2024: 35 · 2023: 35 · 2022: 41 · 2021: 45 · 2020: 35 · 2019: 51 · 2018: 36 · 2017: 37 · 2016: 19 · 2015: 1
- FWCI
- 15.69
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Neurology (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- Brain Research Foundation
- McKnight Foundation
- Evelyn F. McKnight Brain Research Foundation
- Northwestern University (U01-AI35039)
- Johns Hopkins University (U01-AI35039, UM1-AI35043, U01-AI35040)
- University of Pittsburgh
- National Institutes of Health (UL1TR000424, UM1-AI35043)
- Feinberg School of Medicine (U01-AI35040)
- Johns Hopkins Bloomberg School of Public Health (U01-AI35039)
- National Institute of Mental Health (MH075673, P30MH075673)
- National Institute of Allergy and Infectious Diseases (UM1AI035043, U01AI035040, AI035042, U01AI035039, U01AI035042)
- National Institute of Neurological Disorders and Stroke (R01NS081196, NS081196)
- National Center for Advancing Translational Sciences
- Topics
- Life Sciences › Immunology and Microbiology › Virology › HIV Research and Treatment
- Health Sciences › Medicine › Emergency Medicine › HIV-related health complications and treatments
- Health Sciences › Medicine › Surgery › Infectious Diseases and Tuberculosis
- Keywords
- HIV-associated neurocognitive disorders, prevalence, Multicenter AIDS Cohort Study, gay and bisexual men, asymptomatic neurocognitive impairment, hypercholesterolemia, highly active antiretroviral therapy, viral suppression, neuropsychological assessment, functional assessment
- MeSH terms
- Adult, Follow-Up Studies, Humans, Hypercholesterolemia, Male, Middle Aged, Neuropsychological Tests, Severity of Illness Index, AIDS Dementia Complex, Comorbidity, Prevalence, Disease Progression, Antiretroviral Therapy, Highly Active
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