{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T05:26:34Z","timestamp":1772515594947,"version":"3.50.1"},"reference-count":40,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2012,9,20]],"date-time":"2012-09-20T00:00:00Z","timestamp":1348099200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["HIV Medicine"],"published-print":{"date-parts":[[2013,2]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>The aim of the study was to determine the risk factors predictive of symptomatic <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content>\u2010associated neurocognitive disorders (<jats:styled-content style=\"fixed-case\">sHAND<\/jats:styled-content>) among <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content>\u2010infected patients receiving active medical care.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Baseline demographic and clinical characteristics were analysed in patients with <jats:styled-content style=\"fixed-case\">sHAND<\/jats:styled-content> (<jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content>\u2010associated dementia and minor neurocognitive disorder) in a population\u2010based longitudinal cohort of <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content>\u2010infected patients with access to universal health care, including combination antiretroviral therapy (<jats:styled-content style=\"fixed-case\">cART<\/jats:styled-content>) from 1999 to 2008. Variables evaluated for their association with <jats:styled-content style=\"fixed-case\">sHAND<\/jats:styled-content> included age and ethnicity, survival duration with <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content>\u20101 infection, vascular disease risk factors, and laboratory indices such as blood <jats:styled-content style=\"fixed-case\">CD4 T<\/jats:styled-content>\u2010cell count at its nadir and at <jats:styled-content style=\"fixed-case\">cART<\/jats:styled-content> initiation, using both univariable and multivariable logistic regression models.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 1320 patients were investigated, including the patients diagnosed with <jats:styled-content style=\"fixed-case\">sHAND<\/jats:styled-content> (<jats:italic>n<\/jats:italic>\u2009=\u200990) during the study period. In univariable analyses, increased age, increased length of survival with <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content>, low nadir <jats:styled-content style=\"fixed-case\">CD4<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">CD8<\/jats:styled-content> T\u2010cell counts, high baseline viral load (&gt;\u20091\u2009000\u2009000 <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content>\u20101 <jats:styled-content style=\"fixed-case\">RNA<\/jats:styled-content> copies\/<jats:styled-content style=\"fixed-case\">mL<\/jats:styled-content>), and African origin were predictive of a diagnosis of <jats:styled-content style=\"fixed-case\">sHAND<\/jats:styled-content> (<jats:italic><jats:styled-content style=\"fixed-case\">P<\/jats:styled-content>\u2009<\/jats:italic>&lt;<jats:italic>\u2009<\/jats:italic>0.05). In multivariable analysis, increased age, increased length of survival, low nadir <jats:styled-content style=\"fixed-case\">CD4 T<\/jats:styled-content>\u2010cell counts, and high baseline viral load remained predictive of <jats:styled-content style=\"fixed-case\">sHAND<\/jats:styled-content> (<jats:italic><jats:styled-content style=\"fixed-case\">P<\/jats:styled-content>\u2009<\/jats:italic>&lt;<jats:italic>\u2009<\/jats:italic>0.05). Remarkably, <jats:styled-content style=\"fixed-case\">CD4 T<\/jats:styled-content>\u2010cell counts at <jats:styled-content style=\"fixed-case\">cART<\/jats:styled-content> initiation, hepatitis <jats:styled-content style=\"fixed-case\">C<\/jats:styled-content> virus coinfection, and vascular disease risk factors failed to predict <jats:styled-content style=\"fixed-case\">sHAND<\/jats:styled-content> in both analyses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Increased age and survival duration, lower nadir <jats:styled-content style=\"fixed-case\">CD4 T<\/jats:styled-content>\u2010cell counts, and higher baseline viral load were consistent predictors of the development of <jats:styled-content style=\"fixed-case\">sHAND<\/jats:styled-content> among persons with <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">AIDS<\/jats:styled-content> in universal health care, underscoring the importance 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