Thesis defense Marloes Janssen (Donders series 270)

22 May 2017

Promotor: prof. dr. R. Kessels

Cognitive assessment, wellbeing and brain correlates in HIV-infected patients on cART

Because HIV enters the brain people with HIV may develop cognitive deficits, especially if left untreated. With the introduction of combination antiretroviral therapy (cART) in 1996, HIV changed from a fatal disease to a chronic condition. Symptoms of effectively treated patients, including dementia, vastly declined. However, in clinical practice patients still often report loss of concentration and memory problems.

Marloes Janssen investigated cognitive functioning, psychological wellbeing and brain functioning in Dutch HIV-infected patients who were successfully treated with cART. She compared this group with a healthy HIV-negative control group. Results demonstrated a worse performance of the patients on the cognitive domains speed of information processing and motor function. The nature of the decrements was mild. At one-year follow-up, the patients, again, performed worse on the cognitive domain speed of information processing. Furthermore, lower levels of psychological wellbeing and self-reported quality of life were found in HIV-infected patients in comparison to the healthy participants. Again, the differences in psychological wellbeing and self-reported quality of life were small. With respect to the structural MRI results, she found a small difference in the volumes of the total brain and the thalamus, with the patient group showing smaller volumes. She concluded therefore that HIV infection in and of itself has a relatively minor impact on cognitive functioning, wellbeing and the brain in long-term successfully treated HIV-infected patients.