Impaired neurocognitive function among HIV‐infected Thais on stable antiretroviral therapy for more than 7 years
Bibliographic record
Abstract
Background There are limited data on HIV‐associated neurocognitive disorders (HANDs) from resource‐constraint region and few studies have firm documentation of duration of treatment and suppression of plasma virus. This study aimed to estimate the prevalence of HIV‐related cognitive deterioration among HIV‐infected patients who were on stable ART and to describe the pattern of neurocognitive impairment (NCI), daily life disturbance and associated factors. Methods This was a cross‐sectional evaluation of cognition in a sample of HIV adults at HIV‐NAT, the Thai Red Cross AIDS Research Centre with data captured over a 6‐month period. The Montreal Cognitive Assessment (MoCA), International HIV Dementia Scale (IHDS) and Activities of Daily Living Questionnaire (ADLQ) scale were administered. NCI was defined as a score of ≤10 on the IHDS or <26 on the MoCA. The HIV‐NAT Cohort Database was explored to retrieve sociodemographic data and clinical factors. Results Among the 162 patients evaluated, the mean (±SD) age was 42.8 (±7.3) years and 56.8% were male. HBV and HCV co‐infection frequencies were 11.7% and 7.4%, respectively. The mean (±SD) duration of ART was 9.03 (±3.12) years. Of all, 59.3% were concurrently on protease inhibitor (PI) based regimens. 97.5% had virologic success with HIV‐RNA load of less 200 copies/mL. The prevalence of NCI was 68.5% by MoCA and 75.8% by IHDS. Tests on visuospatial cognition, language and abstraction were most commonly poor scores (81.5%, 89.5% and 74.1%, respectively). Among these, 54.9% and 61.3%, respectively, were asymptomatic without overt daily functioning interference. Daily self‐care and household care were the most commonly endorsed daily activity defects (16.7% and 12.3%, respectively). Remaining as a couple (p=0.001), duration of education <12 years (p<0.001) and heterosexual risk (p=0.001) were associated with NCI. The MoCA and IHDS scales correlated to each other (r2=0.177, p=0.024). Logistic regression demonstrated fewer years of education and remaining as a couple were associated with impaired MoCA scale (P=0.001 and 0.008, respectively). Conclusion Impaired cognitive function is commonly detected among HIV‐infected Thais on stable ART for over 7 years. The frequency of NCI is higher than that reported in other settings. However the performance characteristics of our screens have not been firmly established in this setting and the cut‐off levels used may over‐estimate NCI.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".