Denise Cummins
Sydney District Nursing, Australia
Title: Are current assessment protocols capable of identifying people at risk of HIV associated cognitive impairment?
Biography
Biography: Denise Cummins
Abstract
Background: As People Living with HIV (PLHIV) are susceptible to chronic and comorbid health conditions, including an increased risk of cognitive impairment, HIV Associated Neurocognitive Disorder (HAND) can affect up to 50% of PLHIV causing various levels of disability. HAND is difficult to identify as signs and symptoms are nonspecific and diagnosis is by exclusion. The study is on how health professionals collect information which can show impact on patient’s current and future clinical care. Aim: The aim of this study was to review protocols for which patient information from two specialist HIV interdisciplinary community teams in Sydney, Australia was collected to ascertain if the patient data methods could identify individuals at risk of HAND. Results: A total of 262 files were audited to determine patient demographics, clinical and social history. Results showed mean age of 50 years, a HIV diagnosis of 15 years, 74% lived alone and 45% referred for case management. Those older than 50 years were more likely to have hypertension p=0.057, hyperlipidaemia p=0.04 and hypercholesterolemia p=0.007. HIV clinical risk factors for HAND (CD4 Nadir, current CD4 count, HIV viral load) were inconsistently collected. Conclusion: PLHIV are an ageing population and may develop chronic conditions potentially increasing their risk of HAND. Routine collection of accurate information is important to assist clinicians to identify PLHIV at increased risk of HAND. Additionally, community care teams providing care to PLHIV may be well placed to notice cognitive changes in PLHIV who live alone and may have no other means of continuous clinical observation.