The Neurocognitive Assessment in the Metabolic and Aging Cohort (NAMACO) study: baseline participant profile. HIV Medicine
Metral et al. for the NAMACO study group aimed to examine baseline neurocognitive impairment (NCI) prevalence and factors associated with NCI among patients enrolled in the Neurocognitive Assessment in the Metabolic and Aging Cohort (NAMACO) study.
In brief, the NAMACO study is an ongoing, prospective, longitudinal, multicentre and multilingual study within the Swiss HIV Cohort Study. Between 1 May 2013 and 30 November 2016, 981 patients ≥ 45 years old were enrolled in the study. All underwent standardized neuropsychological (NP) assessment by neuropsychologists. NCI was diagnosed using Frascati criteria and classified as HIV-associated or as related to other factors.
Most patients (942; 96.2%) had viral loads < 50 HIV-1 RNA copies/mL. NCI was identified in 390 patients (39.8%): 263 patients (26.8%) had HIV-associated NCI [249 patients (25.4%) had asymptomatic neurocognitive impairment (ANI)] and 127 patients (13%) had NCI attributable to other factors, mainly psychiatric disorders. There was good correlation between dichotomized and continuous analyses, with NCI associated with older age, non-Caucasian ethnicity, shorter duration of education, unemployment and longer antiretroviral therapy duration.
In conclusion, in this representative nation-wide study over a quarter of aging patients (≥ 45 years old) enrolled in the NAMACO study had HIV-associated NCI, a proportion that may increase as the patient cohort ages, despite optimal viral suppression. Among patients with non-HIV-associated NCI, psychiatric disorders, particularly depression, were prevalent. The longitudinal analysis of NAMACO study participants at 2 and 4 years from baseline will shed light on how NCI develops and may be modified in this cohort.