Predictors of symptomatic HIV‐associated neurocognitive disorders in universal health care

Objectives The aim of the study was to determine the risk factors predictive of symptomatic HIV‐associated neurocognitive disorders (sHAND) among HIV‐infected patients receiving active medical care. Methods Baseline demographic and clinical characteristics were analysed in patients with sHAND (HIV‐associated dementia and minor neurocognitive disorder) in a population‐based longitudinal cohort of HIV‐infected patients with access to universal health care, including combination antiretroviral therapy (cART) from 1999 to 2008. Variables evaluated for their association with sHAND included age and ethnicity, survival duration with HIV‐1 infection, vascular disease risk factors, and laboratory indices such as blood CD4 T‐cell count at its nadir and at cART initiation, using both univariable and multivariable logistic regression models. Results A total of 1320 patients were investigated, including the patients diagnosed with sHAND (n = 90) during the study period. In univariable analyses, increased age, increased length of survival with HIV, low nadir CD4 and CD8 T‐cell counts, high baseline viral load (> 1 000 000 HIV‐1 RNA copies/mL), and African origin were predictive of a diagnosis of sHAND (P