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Association of age and time of disease with HIV-associated neurocognitive disorders: a Japanese nationwide multicenter study

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Abstract

There is no detailed information on the association between age, time of disease, and HIV-associated neurocognitive disorders (HAND). In this prospective study involving 17 medical facilities across Japan, we recruited HIV-infected patients to complete a 14-test neuropsychological battery that assess eight neurocognitive domains. HAND were diagnosed by the Frascati criteria. Of 1399 recruited patients, 728 were enrolled. The prevalence of HAND was 25.3% [13.5% asymptomatic neurocognitive impairment, 10.6% mild neurocognitive disorder (MND), and 1.2% HIV-associated dementia (HAD)]. Tests that assess executive and visuospatial functions showed better diagnostic accuracy than other tests for HAND. Multivariate analysis identified age (≥ 50 years) and incomplete virological suppression as risk factors for MND and HAD and current ART as a protective factor. The prevalence of MND and HAD was low in the early stage of infection (6.3% in ≥ 2 to < 6 years), then increased in the later stage [17.3% in ≥ 11 years, p = 0.001 (vs. ≥ 2 to < 6 years)], independent of age or treatment. Older patients were more likely to show MND or HAD in the early stage of HIV infection (26.7 vs. 8.7% for < 2 years and 17.4 vs. 3.1% for ≥ 2 to < 6 years, p = 0.040 and 0.004, respectively) compared to younger ones. In conclusion, MND and HAD were more commonly found in later years since diagnosis of HIV infection and older patients are at risk of neurocognitive impairment at the early stage of HIV infection. Tests for executive and visuospatial functions seem more sensitive than other tests for diagnosing HAND.

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Acknowledgements

The authors thank all members of the J-HAND study group: Tomoyuki Endo, Yoko Ishida, Mitsuo Okawa, Satoshi Hashino, Takeshi Kondo, and Katsuya Fujimoto of Hokkaido University, School of Medicine, Hiroki Tsukada, Takafumi Tezuka, and Miyuki Takeuchi of Niigata City Hospital, Hiroyuki Gatanaga, Kunihisa Tsukada, Katsuji Teruya, Hirohisa Yazaki, Ikumi Genka, Takahiro Aoki, Daisuke Mizushima, Taiichiro Kobayashi, Yasuaki Yanagawa, Akiko Nakano, Mikiko Ogata, and Yuko Tanaka of AIDS Clinical Center, National Center for Global Health and Medicine, Naruhiko Ishiwada, Noriko Takeuchi, Masako Ishikawa, Reiko Nabae, Moe Tashiro, Ryota Ono, and Takayuki Sakurai of Chiba University, School of Medicine, Yasuo Ota, Ichiro Koga, Takatoshi Kitazawa, Kazunori Senoh, Mihoko Kanbe, and Takahiro Tanaka of Teikyo University, School of Medicine, Toshio Naito, Akihiro Inui, and Shinichi Fukushima of Juntendo University, School of Medicine, Yoshiyuki Yokomaku, Mari Ishihara, Ayuko Matsuoka, and Yuko Mori of Nagoya Medical Center, Hideho Wada, Takashi Sugihara, Hirofumi Fukuda, Aki Yoshitake, Taizo Tasaka, Hidekazu Nakanishi, Yoshiko Matsuhashi, and Toshinori Kondo of Kawasaki Medical University, Tatsuro Sakata, Akiko Iizuka, Kasumi Ishiguro, Makie Okada, Etsuko Kadota, Kaoru Mikasa, Sayoko Oyama, Sanae Saito, Yuri Funada, Takahiro Kinashi, Terumi Hisamoto, and Taira Yano of Fukuyama Medical Center, Teruhisa Fujii, Seiji Saito, Naoya Yamazaki, Nobuko Kihana, Ryoko Ogawa, Izumi Asai, and Asuka Sato of Hiroshima University, School of Medicine, Jun Yamanouchi, Koichiro Suemori, Hidemoto Nakanishi, and Yuichi Murakami of Ehime University, School of Medicine, Hikaru Yamashita of the Department of Psychology, Ehime University, Joh Sato, Asako Usui, Megumi Takiguchi, Tomoko Furunaga, Kaori Kawamoto, Yuki Takeshige, and Toshie Adachi of Kanmon Medical Center, Masahiro Yamamoto, Mariko Tsuji, and Atsuko Sakaki of Kyushu Medical Center, Kazuyoshi Saito, Machie Soga, Misako Tanaka, Katsunori Suzuki, and Mieko Teramoto of Industrial Medical University, Shuzo Matsushita, Toshikazu Miyakawa, Hirotomo Nakata, Tamaki Ogata, Yumiko Ezaki, Akiko Shibuya, Masatoshi Takaki, Saori Ueno, and Kie Takemura of Kumamoto University, School of Medicine, Teruhito Hashiguchi, Teppei Koyama, Yoshinao Furukawa, Kayo Uemura, Heiichiro Hamada, Hiroshi Takashima, Akira Sano, Chihoko Tabata, Satomi Tsuneyoshi, Yayoi Maemura, Yasuo Takeda, Keiko Yachi, Kazuhiro, Takahama, Mihoko Tanaka, Niimi Ishihara, Masakaze Matsushita, Masako Iida, Shinnosuke Miyazato, and Haruka Makiyama of Kagoshima University, School of Medicine, and Masao Tateyama, Kaoru Ue, Shuta Nakamura, Futoshi Higa, Kyoko Miyagi, Saori Maeda, Ichiko Oshiro, Yumiko Hedona, and Yumi Tabata of Ryukyu University, School of Medicine (17 hospitals across Japan).

Funding

This work was supported by a Grant from the National Center for Global Health and Medicine (26-G-102) and the Ministry of Health, Labor, and Welfare of Japan.

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Authors and Affiliations

  1. AIDS Clinical Center, National Center for Global Health and Medicine, 1-21-1, Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan

    Ei Kinai, Kensuke Komatsu, Aki Watanabe, Ai Takahashi-Nakazato, Misao Takano, Yoshimi Kikuchi & Shinichi Oka

  2. Center for Comprehensive Community Medicine, Saga University, Saga, Japan

    Maiko Sakamoto

  3. Department of Infectious Diseases, Chiba University, Chiba, Japan

    Toshibumi Taniguchi & Hidetoshi Igari

  4. Department of Infectious Diseases, Ehime University, Matsuyama, Japan

    Aya Nakao & Kiyonori Takada

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  1. Ei Kinai
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  2. Kensuke Komatsu
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Kinai, E., Komatsu, K., Sakamoto, M. et al. Association of age and time of disease with HIV-associated neurocognitive disorders: a Japanese nationwide multicenter study. J. Neurovirol. 23, 864–874 (2017). https://doi.org/10.1007/s13365-017-0580-6

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