Changes in neurocognitive assessment scores after initiating dolutegravir- versus elvitegravir-based antiretroviral therapy.
Jessica L AdamsYookyung Christy ChoiMichael WestLaura PontiggiaJohn BaxterJomy GeorgePublished in: AIDS care (2020)
This prospective cohort study enrolled people living with HIV initiating antiretroviral therapy (ART) containing the integrase inhibitors, dolutegravir (DTG) or elvitegravir (EVG) and administered the Montreal Cognitive Assessment (MoCA) at baseline and again after approximately six months to compare changes in MoCA scores. The proportion of patients found to have cognitive impairment, as indicated by a MoCA score <26/30, on each agent were also compared and comparisons were made between changes in each domain assessed by the MoCA (visuospatial/executive, naming, attention, language, abstraction, delayed recall, and orientation). Thirty-five evaluable participants were enrolled, 18 on DTG and 17 on EVG. The median [interquartile range(IQR)] age was 44 (32 to 54) years, 63% were male, 57% were African American. The median (IQR) MoCA score at baseline was 25 (23 to 27) with no difference between groups (p=0.249). The median (IQR) change in MoCA score was 0 (-1 to 2) for DTG and 1 (0 to 3) for EVG (p = 0.183). Of those on DTG, 8 (44%) had MoCA scores <26 on follow-up compared to 11 (65%) on EVG (p = 0.229). There were no significant differences in changes in any of the individual MoCA domains.
Keyphrases
- antiretroviral therapy
- hiv infected
- hiv infected patients
- human immunodeficiency virus
- african american
- hiv positive
- hiv aids
- working memory
- cognitive impairment
- end stage renal disease
- ejection fraction
- newly diagnosed
- autism spectrum disorder
- mild cognitive impairment
- bipolar disorder
- hepatitis c virus
- prognostic factors
- patient reported outcomes