The Cognitive Impairment of Elderly Living with Human Immunodeficiency Virus (HIV): A Cross-Sectional Study about the Role of Viral Neurotoxicity

Abstract

Aging with HIV has been associated with a higher frequency of neurocognitive disorders. The auditory evoked potentials P300 evaluate cognitive function. In a cross-sectional study, we analyzed the auditory cognition of elderly living with HIV through P300. We compared 34 HIV-infected elderly undergoing regular treatment to 76 HIV-negative elderly (controls) according to P300 latency and the scores of neuropsychological tests. The groups were stratified into age subgroups: 50 ≥ 59, 60 ≥ 69 and ≥70 years. Each age subgroup infected with HIV was compared to the age subgroup of controls immediately older. HIV group consisted of 20 (61%) men, mean age 61 ± 7 years and controls of 24 (32%) men, mean age 67 ± 4 years. Years of schooling were seven (interquartile range 4/8) in HIV group against four (4/11) in controls (p=0.044). P300 latency was similar between genders in the groups. P300 latency was 353 ± 35 ms in HIV group and 331 ± 29 ms in controls (p=0.006). In within-analysis, P300 latency augmented with the increase of age in HIV group (p=0.001) and remained stable in controls (p=0.252). In between-analysis, P300 latency was delayed in HIV subgroup 60 ≥ 69 as compared to controls ≥70 years (p=0.033) and delayed in HIV subgroup ≥70 years as compared to controls ≥70 years (p<0.001). In neuropsychological tests, HIV group presented poor performance in Nine Hole test (p=0.029) and correlation was found between an altered P300 and poor performance to execute the task with the dominant hand (p=0.043). We concluded that even under regular treatment, HIV infection may accelerate the cognitive impairment in the aging.