Signs and symptoms (S&S) of HAND experienced by PLHIV that can indicate changes in cognition may be a new behaviour (e.g. poorer memory). S&S may be so subtle that they are missed or the PLHIV may attribute the changes to something else, such as being tired, stressed, or busy. If the person has always misplaced …
Ask the person to tell you about any changes they have noticed in themselves. Are you slower in your thinking than you used to be? Are you more forgetful than you used to be? Do you have any difficulty paying attention (e.g. following conversations or the plot of a TV show or movie)? Is it …
Caregivers and loved ones can provide unique insight and collateral history into the person’s behaviour and, if available, are important to include in the discussion. Ask them if they have noticed any changes. Have you noticed any changes in the person’s behaviour? Is the person more forgetful? Has his or her personality changed? Is the …
HIV antiretroviral medication is the cornerstone to treat cognitive impairment (17). Early and continuous viral suppression with ART is associated with improved performance on neuropsychological testing (37). But medication adherence can be difficult for someone experiencing S&S of HAND. When treatment fails and virologic rebound occurs, cognitive function deteriorates. More than 30% of PLHIV may develop …
There are several reasons why early recognition of cognitive impairment is important: People with HIV with cognitive impairment have been shown to be less adherent to HIV medication regimes (33-34). This may lead to drug-resistant HIV, resulting in their current medication regime becoming ineffective (20-21). Morbidity and mortality can then be affected as the person …
Regularly review the PLHIV – annual assessment is recommended. Ask the PLHIV questions about changes they may have noticed. Be aware of risk factors for HAND and other general cognitive impairment. Identify, reduce, and treat preventable cognitive risk factors including: smoking reduce cholesterol and triglycerides. treat hypertension, diabetes, HCV. reduce alcohol intake, reduce or cease …
Cognitive impairment continues to represent substantial personal, societal, and economic burdens and may place an increasing burden on Australian resources, especially as PLHIV age. Early recognition and treatment are paramount and can have a positive impact on quality of life and health outcomes for those living with HIV.
Alford, K., Daley, S., Banerjee, S. et al. “A fog that impacts everything”: a qualitative study of health-related quality of life in people living with HIV who have cognitive impairment. Qual Life Res 31, 3019–3030 (2022). https://doi.org/10.1007/s11136-022-03150-x del Palacio M, Alvarez S, Munoz-Fernandez, MA. HIV-1 infection and neurocognitive impairment in the current era. Rev Med Virol 2012; 22(1): 33-45, …
Elizabeth Crock: Bolton Clarke HIV Program, Melbourne Acknowledgments Jayne Howard: Victorian HIV Service, Alfred Hospital, Melbourne (previous edition) This section explores key issues for nurses in relation to ageing and long-term survival with HIV. Ageing with HIV Accelerated or accentuated ageing Long term survival Multiple losses and grief Mental health and resilience Multimorbidities Disability, respite, …
People who have survived many years with HIV, some from the mid-1980s, are considered long-term survivors. Key predictors of long-term survival include early diagnosis, engagement and retention in HIV care, and timely initiation of ART (8). Specific needs of long-term survivors of HIV include psychological and emotional concerns relating to grief and loss, particularly for …