RESUMO
HIV-associated neurocognitive disorders (HAND) remain frequent even among individuals receiving combined antiretroviral therapy (cART). In addition, HAND may adversely affect the quality of life and adherence to cART. There is scarce epidemiological information about HAND in Latin America. This cross-sectional study recruited HIV-infected patients from a tertiary teaching institution in São Paulo, Brazil, between May 2013 and February 2015. The patients were adults with at least 4 years of education and patients with current neurological or psychiatric diseases were excluded. HAND remain frequent even among individuals receiving cART, use of psychoactive substance, or inability to understand the content for neuropsychological evaluation. We used standardized tools to evaluate depression, use of psychoactive substances, and daily life activities, and we performed a comprehensive neuropsychological examination. HAND was classified using the Frascati criteria. Prevalence of HAND was estimated, and an associated variable of symptomatic HAND was identified by logistic regression. Four-hundred twelve HIV-infected patients were included [male: 281 (68%), mean age of 45.3 years]. Most of them [n = 340 (83.7%)] had an undetectable viral load. The prevalence of HAND was 73.6% (n = 303): 210 (50.9%) had asymptomatic neurocognitive involvement (ANI), 67 (16.2%) had mild neurocognitive disorder (MND), and 26 (6.3%) had HIV-associated dementia (HAD). The univariate logistic regression analysis showed that female gender, age older than 50 years, <11 years of schooling, CD4 count below 200 cells/mm3, presence of previous illnesses (e.g., diabetes, hypertension), opportunistic disease history, and a Beck Depression Inventory (BDI) score between 13 and 19 points were factors associated with symptomatic HAND (MND and HAD). However, a BDI score between 13 and 19 points was the single independent variable associated with symptomatic HAND. HAND was highly prevalent in São Paulo, Brazil, and ANI was the more frequent category of HAND. However, 22.5% of participants had symptomatic HAND. This finding constitutes a challenge in clinical practice. A BDI score between 13 and 19 points was the single independent variable associated with symptomatic HAND.
Assuntos
Complexo AIDS Demência/diagnóstico , Transtornos Cognitivos/epidemiologia , Transtornos Cognitivos/etiologia , Disfunção Cognitiva/diagnóstico , Depressão/epidemiologia , Infecções por HIV/complicações , Infecções por HIV/psicologia , Testes Neuropsicológicos/estatística & dados numéricos , Complexo AIDS Demência/epidemiologia , Complexo AIDS Demência/psicologia , Atividades Cotidianas , Adulto , Idoso , Antirretrovirais/uso terapêutico , Brasil/epidemiologia , Contagem de Linfócito CD4 , Transtornos Cognitivos/diagnóstico , Disfunção Cognitiva/epidemiologia , Estudos Transversais , Depressão/diagnóstico , Depressão/etiologia , Escolaridade , Feminino , Infecções por HIV/tratamento farmacológico , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Escalas de Graduação Psiquiátrica , Qualidade de Vida , Carga ViralAssuntos
Terapia Antirretroviral de Alta Atividade/métodos , Disfunção Cognitiva/tratamento farmacológico , Disfunção Cognitiva/epidemiologia , Infecções por HIV/tratamento farmacológico , Infecções por HIV/epidemiologia , Complexo AIDS Demência/tratamento farmacológico , Complexo AIDS Demência/epidemiologia , Complexo AIDS Demência/psicologia , Terapia Antirretroviral de Alta Atividade/tendências , Disfunção Cognitiva/psicologia , Feminino , Infecções por HIV/psicologia , Humanos , Estados Unidos/epidemiologia , Carga Viral/efeitos dos fármacos , Carga Viral/métodos , Carga Viral/tendênciasRESUMO
BACKGROUND: Prevalence estimates of HIV-associated neurocognitive disorders (HAND) may be inflated. Estimates are determined via cohort studies in which participants may apply suboptimal effort on neurocognitive testing, thereby inflating estimates. Additionally, fluctuating HAND severity over time may be related to inconsistent effort. To address these hypotheses, we characterized effort in the Multicenter AIDS Cohort Study. METHODS: After neurocognitive testing, 935 participants (525 HIV- and 410 HIV+) completed the visual analog effort scale (VAES), rating their effort from 0% to 100%. Those with <100% then indicated the reason(s) for suboptimal effort. K-means cluster analysis established 3 groups: high (mean = 97%), moderate (79%), and low effort (51%). Rates of HAND and other characteristics were compared between the groups. Linear regression examined the predictors of VAES score. Data from 57 participants who completed the VAES at 2 visits were analyzed to characterize the longitudinal relationship between effort and HAND severity. RESULTS: Fifty-two percent of participants reported suboptimal effort (<100%), with no difference between serostatus groups. Common reasons included "tired" (43%) and "distracted" (36%). The lowest effort group had greater asymptomatic neurocognitive impairment and minor neurocognitive disorder diagnosis (25% and 33%) as compared with the moderate (23% and 15%) and the high (12% and 9%) effort groups. Predictors of suboptimal effort were self-reported memory impairment, African American race, and cocaine use. Change in effort between baseline and follow-up correlated with change in HAND severity. CONCLUSIONS: Suboptimal effort seems to inflate estimated HAND prevalence and explain fluctuation of severity over time. A simple modification of study protocols to optimize effort is indicated by the results.
Assuntos
Complexo AIDS Demência/diagnóstico , Complexo AIDS Demência/psicologia , Infecções por HIV/complicações , Infecções por HIV/psicologia , Testes Neuropsicológicos , Autorrelato , Complexo AIDS Demência/epidemiologia , Bissexualidade , Análise por Conglomerados , Etnicidade , Infecções por HIV/tratamento farmacológico , Homossexualidade Masculina , Humanos , Masculino , Adesão à Medicação/psicologia , Adesão à Medicação/estatística & dados numéricos , Transtornos da Memória/complicações , Transtornos da Memória/psicologia , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Transtornos Relacionados ao Uso de Substâncias/complicações , Transtornos Relacionados ao Uso de Substâncias/psicologiaRESUMO
Neurocognitive impairment (NCI) is frequently observed in patients infected with human immunodeficiency virus (HIV) and results from the compromise of subcortical brain structures by the virus. The manifestations of NCI range from asymptomatic impairment to dementia. In addition to cognitive impairment resulting from HIV infection, other factors such as depression are associated with the loss of cognitive functions. The aim of this study was to estimate the prevalence of NCI in HIV-positive patients in a city in southern Brazil and to establish possible associations for the prevalence of NCI with HIV-related and other risk factors. This cross-sectional study of HIV-positive outpatients was conducted in a specialized care service in the city of Pelotas in Southern Brazil. Sociodemographic data and HIV-related information were collected, and all patients underwent psychiatric and neurocognitive evaluations. The prevalence of NCI among the 392 patients was 54.1% when tracked using the IHDS (International HIV Dementia Scale) and 36.2% when the IHDS was associated with a battery of complementary tests. A bivariate analysis suggested an association of NCI with gender, age, educational level, depression, current CD4 count and lowest CD4 count. The association of NCI with depression remained in the Poisson regression (PR=1.96, 95%CI=1.12-3.42). The prevalence of cognitive impairment in HIV-positive patients estimated in this study is in accordance with international and Brazilian data. Of the factors analyzed, depression showed the greatest evidence of association with neurocognitive loss. Based on our findings, the inclusion of instruments to evaluate depression in our services for patients with HIV and acquired immunodeficiency syndrome (AIDS) is recommended.
Assuntos
Depressão/epidemiologia , Depressão/virologia , Soropositividade para HIV/epidemiologia , Transtornos Neurocognitivos/epidemiologia , Transtornos Neurocognitivos/virologia , Complexo AIDS Demência/complicações , Complexo AIDS Demência/epidemiologia , Complexo AIDS Demência/psicologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Encéfalo/virologia , Brasil/epidemiologia , Contagem de Linfócito CD4 , Estudos Transversais , Escolaridade , Feminino , Soropositividade para HIV/psicologia , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos Neurocognitivos/diagnóstico , Testes Neuropsicológicos , Prevalência , Escalas de Graduação Psiquiátrica , Análise de Regressão , Fatores de Risco , Inquéritos e Questionários , Carga Viral , Adulto JovemRESUMO
Neurocognitive impairment (NCI) is frequently observed in patients infected with human immunodeficiency virus (HIV) and results from the compromise of subcortical brain structures by the virus. The manifestations of NCI range from asymptomatic impairment to dementia. In addition to cognitive impairment resulting from HIV infection, other factors such as depression are associated with the loss of cognitive functions. The aim of this study was to estimate the prevalence of NCI in HIV-positive patients in a city in southern Brazil and to establish possible associations for the prevalence of NCI with HIV-related and other risk factors. This cross-sectional study of HIV-positive outpatients was conducted in a specialized care service in the city of Pelotas in Southern Brazil. Sociodemographic data and HIV-related information were collected, and all patients underwent psychiatric and neurocognitive evaluations. The prevalence of NCI among the 392 patients was 54.1% when tracked using the IHDS (International HIV Dementia Scale) and 36.2% when the IHDS was associated with a battery of complementary tests. A bivariate analysis suggested an association of NCI with gender, age, educational level, depression, current CD4 count and lowest CD4 count. The association of NCI with depression remained in the Poisson regression (PR=1.96, 95%CI=1.12-3.42). The prevalence of cognitive impairment in HIV-positive patients estimated in this study is in accordance with international and Brazilian data. Of the factors analyzed, depression showed the greatest evidence of association with neurocognitive loss. Based on our findings, the inclusion of instruments to evaluate depression in our services for patients with HIV and acquired immunodeficiency syndrome (AIDS) is recommended.
Assuntos
Humanos , Masculino , Feminino , Adolescente , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Adulto Jovem , Soropositividade para HIV/epidemiologia , Transtornos Neurocognitivos/epidemiologia , Transtornos Neurocognitivos/virologia , Depressão/epidemiologia , Depressão/virologia , Encéfalo/virologia , Brasil/epidemiologia , Estudos Transversais , Fatores de Risco , Complexo AIDS Demência/complicações , Complexo AIDS Demência/psicologia , Complexo AIDS Demência/epidemiologia , Soropositividade para HIV/psicologia , Contagem de Linfócito CD4 , Carga Viral , Transtornos Neurocognitivos/diagnóstico , Escolaridade , Testes NeuropsicológicosRESUMO
INTRODUCTION: Combined antiretroviral therapy has enabled human immunodeficiency virus (HIV) carriers to live longer. This increased life expectancy is associated with the occurrence of degenerative diseases, including HIV-associated neurocognitive disorders (HAND), which are diagnosed via a complex neuropsychological assessment. The International HIV Dementia Scale (IHDS) is a screening instrument validated in Brazil for use in the absence of neuropsychological evaluation. HIV patients are frequently diagnosed with depression. We aimed to determine the prevalence of neurocognitive impairment using the IHDS and depressive disorders using the Hamilton Rating Scale for Depression (HAM-D17), compare the IHDS performance with the performances on the Timed Gait Test (TGT), the Digit Symbol Coding Test (DS) and the Brazilian version of the Scale of Instrumental Activities of Daily Living (IADL), and evaluate the association between the IHDS performance and clinical-demographic variables. METHODS: One hundred fourteen patients were evaluated in a cross-sectional study conducted in a public outpatient clinic for infectious diseases in Marília City, State of São Paulo, Brazil. Data were collected following consultation. Statistical analysis was performed in accordance with the nature and distribution of the data and hypotheses. RESULTS: According to the IHDS, 53.2% of the sampled patients were neuropsychologically impaired. According to the HAM-D17, 26.3% had depressive disorders. There were significant associations between the IHDS and the TGT and DS. Multiple regression analysis indicated that female gender, educational level, and cluster of differentiation 4 (CD4) levels were significantly and independently associated with neurocognitive impairment. CONCLUSIONS: The prevalence of neurocognitive impairment according to the IHDS is high and associated with female gender, education level, and low CD4 levels.
Assuntos
Complexo AIDS Demência/epidemiologia , Depressão/epidemiologia , Complexo AIDS Demência/psicologia , Adulto , Idoso , Brasil/epidemiologia , Estudos Transversais , Depressão/diagnóstico , Depressão/etiologia , Escolaridade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos , Prevalência , Escalas de Graduação Psiquiátrica , Fatores de Risco , Adulto JovemRESUMO
Combined antiretroviral therapy has enabled human immunodeficiency virus (HIV) carriers to live longer. This increased life expectancy is associated with the occurrence of degenerative diseases, including HIV-associated neurocognitive disorders (HAND), which are diagnosed via a complex neuropsychological assessment. The International HIV Dementia Scale (IHDS) is a screening instrument validated in Brazil for use in the absence of neuropsychological evaluation. HIV patients are frequently diagnosed with depression. We aimed to determine the prevalence of neurocognitive impairment using the IHDS and depressive disorders using the Hamilton Rating Scale for Depression (HAM-D17), compare the IHDS performance with the performances on the Timed Gait Test (TGT), the Digit Symbol Coding Test (DS) and the Brazilian version of the Scale of Instrumental Activities of Daily Living (IADL), and evaluate the association between the IHDS performance and clinical-demographic variables.
One hundred fourteen patients were evaluated in a cross-sectional study conducted in a public outpatient clinic for infectious diseases in Marília City, State of São Paulo, Brazil. Data were collected following consultation. Statistical analysis was performed in accordance with the nature and distribution of the data and hypotheses.
According to the IHDS, 53.2% of the sampled patients were neuropsychologically impaired. According to the HAM-D17, 26.3% had depressive disorders. There were significant associations between the IHDS and the TGT and DS. Multiple regression analysis indicated that female gender, educational level, and cluster of differentiation 4 (CD4) levels were significantly and independently associated with neurocognitive impairment.
The prevalence of neurocognitive impairment ...
Assuntos
Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Complexo AIDS Demência/epidemiologia , Depressão/epidemiologia , Complexo AIDS Demência/psicologia , Brasil/epidemiologia , Estudos Transversais , Depressão/diagnóstico , Depressão/etiologia , Escolaridade , Testes Neuropsicológicos , Prevalência , Escalas de Graduação Psiquiátrica , Fatores de RiscoRESUMO
BACKGROUND: HIV-associated cognitive impairment occurs even in the early stages of infection. Short-term memory, psychomotor speed, attention, and executive functioning are the main capacities affected. Controversy exists regarding whether highly active antiretroviral therapy (HAART) is helpful in combating this process. The objective of the present study is to determine the association between cognitive impairment and HAART in HIV-infected patients from Hospital Regional de Huacho. METHODS: Prospective study of HIV patients meeting criteria to start HAART. Twenty-one HIV-positive patients were recruited between April and July 2011. Researchers administered a standardised neuropsychological test battery before and 4 weeks after onset of HAART. Psychomotor speed, executive function, short term memory (visual and verbal), attention, and visuospatial performance were evaluated. RESULTS: Nineteen patients completed the study (14 males and 5 females). In the pre-HAART evaluation, most patients scored below average on the executive function and psychomotor speed subtests. Psychomotor speed and immediate visual memory improved significantly after four months of treatment with HAART. CONCLUSIONS: Some degree of cognitive decline may present even in the early and asymptomatic stages of HIV infection. The benefits of antiretroviral treatment for cognitive performance can be detected after only a few weeks of follow-up.
Assuntos
Terapia Antirretroviral de Alta Atividade , Transtornos Cognitivos/etiologia , Transtornos Cognitivos/psicologia , Infecções por HIV/tratamento farmacológico , Infecções por HIV/psicologia , Complexo AIDS Demência/tratamento farmacológico , Complexo AIDS Demência/psicologia , Adolescente , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos , Peru , Estudos Prospectivos , Resultado do Tratamento , Adulto JovemRESUMO
Antiretroviral therapy has greatly extended the lifespan of people living with human immunodeficiency virus (PLHIV). As a result, the long-term effects of HIV infection, in particular those originating in the central nervous system (CNS), such as HIV associated depression, have gained importance. Animal models for HIV infection have proved very useful for understanding the disease and developing treatment strategies. However, HIV associated depression remains poorly understood and so far there is neither a fully satisfactory animal model, nor a pathophysiologically guided treatment for this condition. Here we review the neuroimmunological, neuroendocrine, neurotoxic and neurodegenerative basis for HIV depression and discuss strategies for employing HIV animal models, in particular humanized mice which are susceptible to HIV infection, for the study of HIV depression.
Assuntos
Complexo AIDS Demência/psicologia , Depressão/virologia , Modelos Animais de Doenças , HIV-1 , Animais , Animais Geneticamente ModificadosRESUMO
OBJECTIVES: We aimed to characterize neurological outcomes and determine the prevalence of HIV encephalopathy in a cohort of HIV-infected children in Jamaica. METHODS: Data for 287 HIV-infected children presenting between 2002 and 2008 were reviewed and neurological outcomes characterized. A nested case-control study was conducted between July and September 2009 used 15 randomly selected encephalopathic HIV-infected children aged 7-10 years and 15 matched controls (non-encephalopathic HIV-infected). Their neurocognitive functions were evaluated using clinical assessment and standardized tests for intelligence, short term memory (visuo-spatial and auditory), selective attention, and fine motor and coordination functions. Outcomes were compared using Fisher's exact test and the Mann-Whitney U-test. RESULTS: Sixty-seven (23.3%) children were encephalopathic. The median age at diagnosis of HIV encephalopathy was 1.6 years (interquartile range (IQR) 1.1-3.4 years). Predominant abnormalities were delayed milestones (59, 88.1%), hyperreflexia (59, 86.5%), spasticity (50, 74.6%), microcephaly (42, 61.7%), and quadriparesis (21, 31.3%). The median age of tested children was 8.7 years (IQR 7.6-10.8 years) in the encephalopathic group and 9 years (IQR 7.4-10.7 years) in the non-encephalopathic group. Encephalopathic children performed worse in all domains of neurocognitive function (p<0.05). CONCLUSIONS: A high prevalence of HIV encephalopathy was noted, and significant neurocognitive dysfunction identified in encephalopathic children. Optimized management through the early identification of neurological impairment and implementation of appropriate interventions is recommended to improve quality of life.
Assuntos
Complexo AIDS Demência/psicologia , Transtornos Cognitivos/virologia , Países em Desenvolvimento , Complexo AIDS Demência/tratamento farmacológico , Complexo AIDS Demência/epidemiologia , Fármacos Anti-HIV/uso terapêutico , Terapia Antirretroviral de Alta Atividade , Estudos de Casos e Controles , Criança , Pré-Escolar , Transtornos Cognitivos/epidemiologia , Humanos , Lactente , Jamaica/epidemiologia , Deficiências da Aprendizagem/epidemiologia , Deficiências da Aprendizagem/virologia , Transtornos da Memória/epidemiologia , Transtornos da Memória/virologia , Microcefalia/epidemiologia , Microcefalia/virologia , Prevalência , Qualidade de Vida , Reflexo AnormalRESUMO
HIV-associated neurocognitive disorders (HAND) continue to be a neurological complication of HIV infection in the era of combined antiretroviral therapy. Hippocampal neurodegeneration and dysfunction occurs as a result of HIV infection, but few studies to date have assesses spatial learning and memory function in patients with HAND. We used the Memory Island (MI) test to study the effects of HIV infection, apolipoprotein E (ApoE) allele status, and cerebral spinal fluid (CSF) ApoE protein levels on spatial learning and memory in our cohort of Hispanic women. The MI test is a virtual reality-based computer program that tests spatial learning and memory and was designed to resemble the Morris Water Maze test of hippocampal function widely used in rodent studies. In the current study, HIV-seropositive women (n = 20) and controls (n = 16) were evaluated with neuropsychological (NP) tests, the MI test, ApoE, and CSF ApoE assays. On the MI, the HIV-seropositive group showed significant reduced learning and delayed memory performance compared with HIV-seronegative controls. When stratified by cognitive performance on NP tests, the HIV-seropositive, cognitively impaired group performed worse than HIV-seronegative controls in ability to learn and in the delayed memory trial. Interestingly, differences were observed in the results obtained by the NP tests and the MI test for ε4 carriers and noncarriers: NP tests showed effects of the ε4 allele in HIV-seronegative women but not HIV-seropositive ones, whereas the converse was true for the MI test. Our findings suggest that the MI test is sensitive in detecting spatial deficits in HIV-seropositive women and that these deficits may arise relatively early in the course of HAND.
Assuntos
Complexo AIDS Demência/psicologia , Apolipoproteínas/líquido cefalorraquidiano , Cognição , Soropositividade para HIV/psicologia , Aprendizagem , Complexo AIDS Demência/líquido cefalorraquidiano , Complexo AIDS Demência/virologia , Adulto , Alelos , Apolipoproteínas/genética , Estudos de Casos e Controles , Feminino , Expressão Gênica , Soropositividade para HIV/líquido cefalorraquidiano , Soropositividade para HIV/virologia , Hipocampo/patologia , Hispânico ou Latino , Humanos , Estudos Longitudinais , Memória , Pessoa de Meia-Idade , Testes Neuropsicológicos , Tempo de ReaçãoRESUMO
BACKGROUND: The study was undertaken to describe the frequency of HIV-associated neurocognitive disorders (HAND) and depressive symptoms in an older population with human immunodeficiency virus (HIV). METHODS: A cross-sectional analysis of patients aged 50 years or older infected with HIV was carried out in an outpatient setting in Brazil from March to November 2008. Patients selected were submitted to cognitive evaluation using the Mini-Mental State Examination and International HIV Dementia Scale, and also to functional and depression evaluations. RESULTS: Among the 52 patients evaluated, the frequency of neurocognitive disorder was 36.5%, while for dementia the frequency was 13.5%. No risk factors were identified. Among the patients with cognitive impairment, 73.7% had cortical impairment. The frequency of depressive symptoms was of 34.6%. The female gender was identified as a risk factor (p = 0.018) and patients with depressive symptoms had greater functional impairment (p < 0.001). CONCLUSION: HAND and depressive symptoms are common in an older population. Patients with cognitive impairment achieved lower scores on the cortical assessment scales. Depressive symptoms are a stronger factor for functional impairment.
Assuntos
Complexo AIDS Demência/epidemiologia , Depressão/etiologia , Infecções por HIV/psicologia , Complexo AIDS Demência/etiologia , Complexo AIDS Demência/psicologia , Brasil/epidemiologia , Distribuição de Qui-Quadrado , Estudos Transversais , Depressão/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos , Escalas de Graduação Psiquiátrica , Fatores de Risco , Fatores Sexuais , Estatísticas não ParamétricasRESUMO
OBJECTIVE: To evaluate neurocognitive performance in patients with preserved immunological status using the International HIV Dementia Scale (IHDS) and compare patients on and off highly active antiretroviral therapy (HAART). DESIGN: Cross-sectional study. METHODS: Outpatients with more than 350 CD4 cells per cubic millimeter underwent evaluation by means of the IHDS, a cross-cultural scale designed to identify HIV-positive patients at risk for dementia. RESULTS: A total of 260 patients were included, 158 on HAART and viral load <1000 copies per mL and 102 treatment naïve. Mean age was 38.2 (SD 8.03) years, 86% were male. Mean score was 10.9 (SD 1.77). Only age correlated with a significantly different score; younger patients performed better. When patients on and off HAART were compared, we found no significant differences in age, sex, time from diagnosis, educational level, risk factor for HIV acquisition, and current CD4 count. CD4 nadir was lower for patients on HAART: 246.0 (200.95) vs. 492.7 (233.33), P < 0.001. There was no difference between the scores obtained by patients on and off HAART (mean 11.0, SD 2.08; mean 10.8, SD 1.17; respectively, P = 0.70). There was no difference according to efavirenz use. CONCLUSIONS: Patients with preserved immunity performed well on IHDS. It didn't seem to be any difference between patients on and off HAART regarding neurocognitive status.
Assuntos
Complexo AIDS Demência/diagnóstico , Complexo AIDS Demência/psicologia , HIV-1 , Testes Neuropsicológicos/normas , Complexo AIDS Demência/tratamento farmacológico , Adulto , Distribuição por Idade , Idoso , Fármacos Anti-HIV/uso terapêutico , Terapia Antirretroviral de Alta Atividade , Cognição , Estudos Transversais , Feminino , Infecções por HIV/tratamento farmacológico , Infecções por HIV/psicologia , Humanos , Masculino , Pessoa de Meia-Idade , Sensibilidade e Especificidade , Adulto JovemRESUMO
The mental health professional should be aware of any organic mental disorder in the HIV-seropositive patient, since they are more exposed to this mind of disorders than the general population. The purpose of this study is to provide general guidelines for the early detection of these disorders, giving information on their causes and deeping in the date available on the AIDS-related complex (organic mental disorder specifically related with AIDS).
Assuntos
Complexo AIDS Demência/etiologia , Transtornos Neurocognitivos/etiologia , Complexo AIDS Demência/diagnóstico , Complexo AIDS Demência/psicologia , Transtornos Cognitivos/etiologia , Soropositividade para HIV/complicações , Humanos , Transtornos Neurocognitivos/diagnóstico , Transtornos Neurocognitivos/psicologia , Transtornos Psicomotores/etiologia , Índice de Gravidade de DoençaRESUMO
A report of four AIDS-related psychiatric cases in Honduras is presented. (2,544 AIDS cases have been reported up to April '93. In the sole city of San Pedro Sula, 1,000 cases have been reported). Measures are suggested for an improved psychiatrical and psychological care of patients (either seropositive patients or AIDS healthy carriers): the former would be helped toward a smoother acceptance of an impending death, the latter could be in a better position to fight against social prejudice and discrimination.
Assuntos
Síndrome da Imunodeficiência Adquirida/psicologia , Complexo AIDS Demência/psicologia , Complexo AIDS Demência/terapia , Síndrome da Imunodeficiência Adquirida/terapia , Adulto , Feminino , Seguimentos , Humanos , Masculino , Apoio SocialRESUMO
Se presenta el informe de cuatro casos psiquiátricos relacionados con el SIDA en Honduras donde, hasta abril de 1993 se han reportado 2.544casos. Sólo en la ciudad de San Pedro Sula, se han reportado 1.000 casos -. Se Sugieren medidas para la mejor atención psiquiátrica y psicológica de los enfermos (tanto los eropositivos como los portadores sanos): en unos, para suavizar el tránsito hacia la muerte; en los otros, para tratar de reducir la discriminación social de la que son objeto
Assuntos
Humanos , Masculino , Feminino , Adulto , Síndrome da Imunodeficiência Adquirida/psicologia , Complexo AIDS Demência/psicologia , Complexo AIDS Demência/terapia , Seguimentos , Manifestações Neurológicas , Síndrome da Imunodeficiência Adquirida/terapiaRESUMO
Se presenta el informe de cuatro casos psiquiátricos relacionados con el SIDA en Honduras donde, hasta abril de 1993 se han reportado 2.544casos. Sólo en la ciudad de San Pedro Sula, se han reportado 1.000 casos -. Se Sugieren medidas para la mejor atención psiquiátrica y psicológica de los enfermos (tanto los eropositivos como los portadores sanos): en unos, para suavizar el tránsito hacia la muerte; en los otros, para tratar de reducir la discriminación social de la que son objeto (AU)
Assuntos
Humanos , Masculino , Feminino , Adulto , Síndrome da Imunodeficiência Adquirida/psicologia , Síndrome da Imunodeficiência Adquirida/terapia , Complexo AIDS Demência/psicologia , Complexo AIDS Demência/terapia , Manifestações Neurológicas , SeguimentosRESUMO
The progressive confirmation of the neurotropic character of HIV, in juxtaposition to the recognition of AIDS dementia complex as an important central nervous system clinical manifestation, have engendered a greater interest in this phenomena. Consequently, a more precise description of the behavioral and mental aspects of this infection have evolved. This article has two purposes, to discuss the AIDS dementia complex concept and secondly, to review the neuropsychiatric and neuropsychological aspects of infection by HIV and AIDS, as it pertains to adult patients.
Assuntos
Complexo AIDS Demência/psicologia , Doenças do Sistema Nervoso Central/etiologia , Infecções por HIV/complicações , Eletrofisiologia/métodos , Infecções por HIV/psicologia , Soropositividade para HIV/psicologia , Humanos , Transtornos Neurocognitivos/etiologia , Testes Neuropsicológicos , Infecções Oportunistas/complicaçõesRESUMO
The progressive confirmation of the neurotropic character of HIV, in juxtaposition to the recognition of AIDS dementia complex as an important central nervous system clinical manifestation, have engendered a greater interest in this phenomena. Consequently, a more precise description of the behavioral and mental aspects of this infection have evolved. This article has two purposes, to discuss the AIDS dementia complex concept and secondly, to review the neuropsychiatric and neuropsychological aspects of infection by HIV and AIDS, as it pertains to adult patients