Association between Veterans Aging Cohort Study (VACS) index and neurocognitive function among people living with HIV–a cross sectional study in coastal South India

*, Basavaprabhu A and Madi, Deepak R and D'Souza, Nikhil Victor and Holla, Ramesh and *, Soundarya M and *, Unnikrishnan B and *, Priya Rathi and *, Archana Ganapathy (2021) Association between Veterans Aging Cohort Study (VACS) index and neurocognitive function among people living with HIV–a cross sectional study in coastal South India. AIDS Research and Therapy, 18 (1). pp. 1-11. ISSN 17426405

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Abstract

Background: HIV is an infectious disease afecting 36.7 million people worldwide. In recent times, Antiretroviral Therapy (ART) has become accessible to the majority of People Living with HIV (PLHIV) and this has transformed the course of infection to one that is chronic, characterized by fewer diseases pathognomonic of AIDS. In view of this, there is a pressing need for better markers, apart from the routine HIV indicators, to detect comorbidities such as Neurocognitive Impairment (NCI). The aim of this study was to fnd out the association between Veterans Aging Cohort Study (VACS) index and Neurocognitive function in HIV positive patients. Methods: In our study, we included 97 HIV positive patients and their Neurocognitive function was assessed using a combination of Montreal Cognitive Assessment and Grooved Pegboard Test, while VACS index was calculated using the most recent laboratory values. Binomial Logistics Regression analyses, adjusting for potential confounding variables, was performed to determine the association between VACS score and Neurocognitive Impairment. Results: We found that a higher VACS Index was associated with global and domain-wise Neurocognitive impairment (p<0.01), specifcally in the domains of attention (p<0.01) and fne motor skills (p=0.01). Our study also showed that among all the VACS components, older age (p=0.02) and lower hemoglobin (p<0.01) values were associated with global NCI. After plotting an ROC curve, a VACS cut-of score of 11.00 was identifed as it had good sensitivity (87.0%) and specifcity (71.4%) in identifying Global NCI. Conclusion: Our fndings extend prior research on the use of VACS Index to predict global and domain-wise NCI in HIV-positive patients. However, further research with more comprehensive neurocognitive testing is required in our setting before VACS Index can be used as a tool to screen for neurocognitive dysfunction among PLHIV

Item Type: Article
Uncontrolled Keywords: HIV, Comorbidity, Cognition, VACS Index, CD4 cell count
Subjects: Medicine > KMC Mangalore > Paediatrics
Medicine > KMC Mangalore > Community Medicine
Medicine > KMC Mangalore > Medicine
Depositing User: KMCMLR User
Date Deposited: 17 Dec 2021 11:03
Last Modified: 17 Dec 2021 11:03
URI: http://eprints.manipal.edu/id/eprint/157863

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