Neurocognitive Impairment in Patients with HIV and Depression in Nigeria

Abstract

HIV has been associated with neurocognitive impairment which may be due to the direct effect of the virus, indirect effect or due to medications side effects or due to a combination of factors. HIV and depression have been shown separately to have neurocognitive deficits. Aim: Determine the prevalence of NCI and factors associated with it among depressed and non-depressed patients with HIV on combined antiretroviral treatment (cART). Methodology. A descriptive comparative cross-sectional study was conducted among People living with HIV (PLHIV) at Aminu Kano Teaching Hospital in Kano State, northern Nigeria. Participants were grouped into HIV with depression and HIV without depression groups based on current diagnosis using the depression module of the MINI International Neuropsychiatric Interview (MINI)-7th edition. A multi-domain neuropsychological battery (MDNPT) of 5 tests (assessed 5 cognitive domains) was used to diagnose Neurocognitive impairment. Results: Fifty-seven percent of the study sample were females, and the mean age of the participants was 37.54 (±10.04) years with an age range of 18-65 years. The prevalence of NCI was 74% among the depressed 68.3% among the non-depressed group (p=0.484). Years of education and IHDS score were significantly associated with NCI in the depressed group (p < 0.05 respectively). While among the non-depressed group, Years of education, average monthly income and IHDS score were significantly associated with NCI (p < 0.05 respectively). Conclusion: Neurocognitive impairment occurs in HIV-positive patients but is worsened by a depressive disorder. There is a need to adequately assess and treat HIV patients with depression. Treatment may improve neurocognitive impairment in depressed HIV patients.