Fatores associados aos distúrbios neurocognitivos em pessoas vivendo com HIV com 50 anos ou mais no Brasil: um estudo transversal

Conteúdo do artigo principal

Julio Cesar Matias do Nascimento
Guilherme Welter Wendt
Joana Perotta Titon
Geraldo Emílio Vicentini
Lia Beatriz Henke de Azevedo
Lirane Elize Defante Ferreto

Resumo

Introdução: Há uma alta prevalência de distúrbios neurocognitivos associados ao HIV (HAND’s), especialmente em pessoas vivendo com HIV (PVHIV) ≥50 anos de idade. Objetivo: Identificar os fatores associados com as HAND’s em PVHA com ≥50 anos. Métodos: Trata-se de um estudo transversal envolvendo 48 pacientes (Média=59,6 anos). Foram coletados dados sociodemográficos, clínicos e antropométricos. Atividades instrumentais de vida diária (AIVD) e a Escala Internacional de Demência por HIV (IHDS) foram aplicadas para avaliação neurocognitiva. Resultados: 75% dos indivíduos tinham HAND’s, incluindo 88,89% com distúrbios assintomáticos e 11,11% com distúrbios leves/moderados. Os escores da IHDS correlacionaram-se positivamente com escolaridade, estado nutricional e carga viral no momento do diagnóstico, enquanto negativamente se correlacionaram com o número de doenças, número de medicamentos e glicemia. Conclusão: Até onde sabemos, este parece ser um dos poucos estudos realizados exclusivamente com idosos vivendo com o HIV e que investigou os fatores associados a HAND’s em uma cidade do interior de um país em desenvolvimento, mostrando que os principais preditores de HAND’s foram escolaridade, carga viral no diagnóstico e glicemia. Assim, os resultados podem apoiar futuros estudos e intervenções entre PVHIV em outros lugares, onde os recursos são limitados e a assistência ao HIV pode ser mais precária e difícil.

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Matias do Nascimento, J. C., Wendt, G. W., Titon, J. P., Vicentini, G. E., Azevedo, L. B. H. de, & Ferreto, L. E. D. (2025). Fatores associados aos distúrbios neurocognitivos em pessoas vivendo com HIV com 50 anos ou mais no Brasil: um estudo transversal. ABCS Health Sciences. https://doi.org/10.7322/abcshs.2023152.2440
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Referências

Righetto RC, Reis RK, Reinato LAF, Gir E. Comorbidades e coinfecções em pessoas vivendo com HIV/Aids. Rev Rene. 2014;15(6):942-8. https://doi.org/10.15253/2175-6783.2014000600006

Rojas-Celis V, Valiente-Echeverría F, Soto-Rifo R, Toro-Ascuy D. New Challenges of HIV-1 Infection: How HIV-1 Attacks and Resides in the Central Nervous System. Cells. 2019;8(10):1245. https://doi.org/10.3390/cells8101245

Sartori GP, Domínguez CI, Rodríguez VGF, Dansilio S, Presentado JCM. Trastornos neurocognitivos en pacientes VIH positivos. Datos preliminares de una cohorte prospectiva uruguaya. Rev Med Urug. 2019;35(3):5-30. https://doi.org/10.29193/rmu.35.3.1

Eggers C, Arendt G, Hahn K, Husstedt IW, Maschke M, Neuen-Jacob E, et al. HIV-1-associated neurocognitive disorder: epidemiology, pathogenesis, diagnosis, and treatment. J Neurol. 2017;264(8):1715-27. https://doi.org/10.1007/s00415-017-8503-2

Smail RC, Brew BJ. Chapter 7 - HIV-associated neurocognitive disorder. Handb Clin Neurol. 2018;152:75-97. https://doi.org/10.1016/B978-0-444-63849-6.00007-4

Xiao X, Zeng H, Feng C, Tan H, Wu L, Zhang H, et al. Cognitive Impairment Among Aging People Living with HIV on Antiretroviral Therapy: A Cross-Sectional Study in Hunan, China. J Assoc Nurses AIDS Care. 2020;31(3):301-11. https://doi.org/10.1097/JNC.0000000000000122

Mohamed AA, Oduor C, Kinyanjui D. HIV-associated neurocognitive disorders at Moi teaching and referral hospital, Eldoret, Kenya. BMC Neurol. 2020;20(1):280. https://doi.org/10.1186/s12883-020-01857-3

Rosca EC, Tadger P, Cornea A, Tudor R, Oancea C, Simu M. International HIV Dementia Scale for HIV-Associated Neurocognitive Disorders: A Systematic Review and Meta-Analysis. Diagnostics (Basel). 2021;11(6):1124. https://doi.org/10.3390/diagnostics11061124

Freitas EV, Miranda RD. Parâmetros clínicos do envelhecimento e avaliação geriátrica ampla. In: Tratado de geriatria e gerontologia. 2nd ed. Rio de Janeiro: Guanabara Koogan; 2016.

Masnoon N, Shakib S, Kalisch-Ellett L, Caughey GE. What is polypharmacy? A systematic review of definitions. BMC Geriatr. 2017;17:230. https://doi.org/10.1186/s12877-017-0621-2

Vale FC, Santa-Helena ET, Santos MA, Carvalho WMES, Menezes PR, Basso CR, et al. Development and validation of the WebAd-Q Questionnaire to monitor adherence to HIV therapy. Rev Saude Publica. 2018;52:62. https://doi.org/10.11606/S1518-8787.2018052000337

Guigoz Y. The Mini Nutritional Assessment (MNA) review of the literature- What does it tell us? J Nutr Health Aging. 2006;10(6):466-85.

Rodrigues RA, Oliveira RL, Grinsztejn B, Silva MTT. Validity of the International HIV Dementia Scale in Brazil. Arq Neuro-Psiquiatr. 2013;71(6):376-9.

Vellas B, Guigoz Y, Garry PJ, Nourhashemi F, Bennahum D, Lauque S, et al. The Mini Nutritional Assessment (MNA) and its use in grading the nutritional state of elderly patients. Nutrition. 1999;15(2):116-22. https://doi.org/10.1016/s0899-9007(98)00171-3

Paradela EMP, Lourenço RA, Veras RP. Validação da escala de depressão geriátrica em um ambulatório geral. Rev Saude Pública. 2005;39(6):918-23. https://doi.org/10.1590/S0034-89102005000600008

Cruz-Jentoft AJ, Baeyens JP, Bauer JM, Boirie Y, Cederholm T, Landi F, et al. Sarcopenia: European consensus on definition and diagnosis: Report of the European Working Group on Sarcopenia in Older People. Age Ageing. 2010;39(4):412-23. https://doi.org/10.1093/ageing/afq034

Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J, et al. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci. 2001;56(3):M146-56. https://doi.org/10.1093/gerona/56.3.m146

Lima LRA, Rech CR, Petroski EL. Utilização da impedância bioelétrica para estimativa da massa muscular esquelética em homens idosos. ALAN. 2008;58(4):386-91.

Rech CR, Salomons E, Lima LRA, Petroski EL, Glaner MF. Validity of bioelectrical impedance analysis for the estimation of skeletal muscle mass in elderly women. Rev Bras Med Esporte. 2010;16(2):95-8. https://doi.org/10.1590/S1517-86922010000200003

Janssen I, Heymsfield SB, Baumgartner RN, Ross R. Estimation of skeletal muscle mass by bioelectrical impedance analysis. J Appl Physiol (1985). 2000;89(2):465-71. https://doi.org/10.1152/jappl.2000.89.2.465

Sacktor NC, Wong M, Nakasujja N, Skolasky RL, Selnes OA, Musisi S, et al. The International HIV Dementia Scale: a new rapid screening test for HIV dementia. AIDS. 2005;19(13):1367-74.

Duarte EAC, Benevides ML, Martins ALP, Duarte EP, Weller ABS, Azevedo LOC, et al. Female sex is strongly associated with cognitive impairment in HIV infection. Neurol Sci. 2021;42(5):1853-60. https://doi.org/10.1007/s10072-020-04705-x

Animut MD, Sorrie MB, Birhanu YW, Teshale MY. High prevalence of neurocognitive disorders observed among adult people living with HIV/AIDS in Southern Ethiopia: A cross-sectional study. Plos One. 2019;14(3):e0204636. https://doi.org/10.1371/journal.pone.0204636

Mugendi AG, Kubo MN, Nyamu DG, Mwaniki LM, Wahome SK, Haberer JE. Prevalence and Correlates of Neurocognitive Disorders among HIV Patients on Antiretroviral Therapy at a Kenyan Hospital. Neurol Res Int. 2019;2019:5173289. https://doi.org/10.1155/2019/5173289

Lawton MP, Brody EM. Assessment of Older People: Self-Maintaining and Instrumental Activities of Daily Living. Gerontologist. 1969;9(3):179-86.

Chan FCC, Chan P, Chan I, Chan A, Tang THC, Lam W, et al. Cognitive screening in treatment-naïve HIV-infected individuals in Hong Kong - a single center study. BMC Infect Dis. 2019;19(1):156. https://doi.org/10.1186/s12879-019-3784-y

Pinheiro CAT, Souza LDM, Motta JVS, Kelbert EF, Martins CSR, Souza MS, et al. Aging, neurocognitive impairment, and adherence to antiretroviral therapy in human immunodeficiency virus-infected individuals. Braz J Infect Dis. 2016;20(6):599-604. https://doi.org/10.1016/j.bjid.2016.09.006

Milanini B, Allen I, Paul R, Bahemana E, Kiweewa F, Nambuya A, et al. Frequency and Predictors of HIV-Related Cognitive Impairment in East Africa: The Africa Cohort Study (AFRICOS). J Acquir Immune Defic Syndr. 2020;83(2):157-64. https://doi.org/10.1097/QAI.0000000000002242

Mohamed AA, Oduor C, Kinyanjui D. HIV-associated neurocognitive disorders at Moi teaching and referral hospital, Eldoret, Kenya. BMC Neurol. 2020;20(1):280. https://doi.org/10.1186/s12883-020-01857-3

Haddow LJ, Laverick R, Daskalopoulou M, McDonnell J, Lampe FC, Gilson R, et al. Multicenter European Prevalence Study of Neurocognitive Impairment and Associated Factors in HIV Positive Patients. AIDS Behav. 2018;22(5):1573-83. https://doi.org/10.1007/s10461-017-1683-z

Nyamayaro P, Gouse H, Hakim J, Robbins RN, Chibanda D. Neurocognitive impairment in treatment-experienced adults living with HIV attending primary care clinics in Zimbabwe. BMC Infect Dis. 2020;20(1):383. https://doi.org/10.1186/s12879-020-05090-8

Gascon MR, Lima M, Cheutchuk PM, Oliveira EA, Oliveira GS, Gualqui CF, et al. High prevalence of HIV-associated neurocognitive disorders (HAND) in São Paulo City, Brazil. Rev Bras Neurol. 2021;57(1):6-12. https://doi.org/10.46979/rbn.v57i1.43075

Távora LGF, Figueiredo TM, Mesquita RMK, Bezerra FR, Aquino BP, Colares JKB. HIV and dementia: Prevalence and risk factors. Rev Bras Promoç Saude. 2016;29(2):212-8. https://doi.org/10.5020/18061230.2016.p212

Sun-Suslow N, Paolillo EW, Morgan EE, Letendre S, Iudicello J, Moore DJ. Brief Report: Frailty and HIV Disease Severity Synergistically Increase Risk of HIV-Associated Neurocognitive Disorders. Acquire Immune Defic Syndr. 2020;84(5):522-6. https://doi.org/10.1097/QAI.0000000000002391

Yuan NY, Kaul M. Beneficial, and Adverse Effects of cART Affect Neurocognitive Function in HIV-1 Infection: Balancing Viral Suppression against Neuronal Stress and Injury. J Neuroimmune Pharmacol. 2021;16(1):90-112. https://doi.org/10.1007/s11481-019-09868-9

Valcour V, Shikuma C, Shiramizu B, Watters M, Poff P, Selnes O, et al. Higher frequency of dementia in older HIV-1 individuals: The Hawaii Aging with HIV-1 Cohort. Neurology. 2004;63(5):822-7. https://doi.org/10.1212/01.wnl.0000134665.58343.8d

Banerjee N, McIntosh RC, Ironson G. Impaired Neurocognitive Performance and Mortality in HIV: Assessing the Prognostic Value of the HIV-Dementia Scale. AIDS Behav. 2019;23(12):3482-92. https://doi.org/10.1007/s10461-019-02423-w

Joska JA, Dreyer AJ, Nightingale S, Combrinck MI, Jager CA. Prevalence of HIV-1 Infection in an elderly rural population and associations with neurocognitive impairment. AIDS. 2019;33(11):1765-71. https://doi.org/10.1097/QAD.0000000000002257

Mone P, Gambardella J, Pansini A, Donato A, Martinelli G, Boccalone E, et al. Cognitive Impairment in Frail Hypertensive Elderly Patients: Role of Hyperglycemia. Cells. 2021;10(8):2115. https://doi.org/10.3390/cells10082115

Herzlich BC, Schiano TD. Reversal of apparent AIDS dementia complex following treatment with vitamin B12. J Intern Med. 1993;233(6):495-7. https://doi.org/10.1111/j.1365-2796.1993.tb01005.x