Science & Technology, Australia (Commonwealth Union) – The human immunodeficiency virus (HIV) binds to the surface of helper T-cells and makes copies of itself within the helper T-cells and eventually destroys them. Unlike many decades ago, presently researchers have much more knowledge on HIV together with many more treatments, however room for further improvement still exists.
Researchers have indicated that mental health should also be a critical factor to look into.
Treatment can lower the amounts of HIV in the blood to an undetectable level with a majority of persons with the infection on medication can live as long as persons having no HIV.
With successful developments in the treatment of the virus, it is essential to know, the effect it has on long-term cognitive function for persons growing older with HIV.
Associate Professor Lucette Cysique at the School of Psychology, from The University of New South Wales (UNSW), and her team performed long-term research on the cognitive function of individuals ageing with chronic stable HIV infection, in 17 care facilities all over Australia, which was published in eClinicalMedicine.
Researchers discovered that persons with stable HIV infection, who take their medication, are not likely to demonstrate significant cognitive decline while growing older. However certain factors making individuals more vulnerable to subtle cognitive lowering, that include lower mental health, social isolation and lesser socioeconomic status.
“Like any chronic condition that demands a life-long treatment, it’s important for us to determine whether people with HIV may require extra care as a result of mental and cognitive health changes as they reach their 60s,” said Associate Professor Cysique.
The researchers that functioned as a multidisciplinary team, with infectious disease physicians to neuroscientists analyzed the cognitive functions of 457 people with HIV more than 2 years.
The participants were evaluated on a brief cognitive screening test, assessing factors like memory, learning, attention and cognition. The study analyzed a wide range of information on psychosocial and socioeconomic determinants for health.
The findings demonstrated that at 12 months and 24 months, only 6% and 7% of people respectively revealed significant, cognitive decline. These figures reflect the general population of the same age (average age 51, plus or minus 12).
But, over the same periods, 31% and 25% of participants indicated subtle cognitive changes. This mild cognitive reduction could be linked to minor, ongoing changes in the brain among individuals with HIV, despite having extremely minor amounts of HIV in the blood, as indicated in the study.
Researchers also observed that financial instability, social isolation and severe depression were linked to poorer cognitive health.
The research is just a component of the puzzle that is hoping to bring the messaging around cognitive health and persons with HIV, particularly in Australia, to greater focus, Associate Professor Cysique indicated that she hopes that future studies can build on long-term observational research in persons in their 70s and in time be combined with interventional studies where solutions tackling and enhancing cognitive and mental health are put to the test.
Further research would also be required to capture how mild cognitive alterations may be impacting a person’s ability to perform daily tasks and their quality of life.
“We want to move towards a holistic care approach for people ageing with HIV, one that encompasses cognitive and mental health, and care delivery that is stigma-free. Our group is currently working with researchers, clinicians and HIV community representatives internationally to develop adapted care plans.”
“People with HIV have historically been a self-empowered patient group that has contributed to changing the doctor/scientist and patient relationship for the better. Today, clinical research emphasises the contribution of patient groups in research projects. People with HIV were pioneers in this way, and they continue to advocate for their care as they age.”
