Neuropsychological assessment of cognitive deficits in people living with HIV receiving antiretroviral therapy

The introduction of antiretroviral therapy (ART) has substantially reduced opportunistic infections and significantly increased the life expectancy of people living with HIV (PLHIV). Despite these advances, HIV-associated neurocognitive alterations—collectively known as HIV-associated neurocognitive disorders (HAND)—continue to be observed even in individuals receiving effective treatment. The present study aimed to evaluate potential cognitive deficits in PLHIV undergoing ART and to characterize the clinical profile of neurocognitive manifestations. Thirty HIV-positive individuals aged between 18 and 40 years participated in the study. All participants had been receiving the antiretroviral regimen tenofovir, lamivudine, and dolutegravir (TDF/3TC + DTG) for at least one year. The assessment protocol included a sociodemographic questionnaire, the Instrumental Activities of Daily Living Scale (IADL), the International HIV Dementia Scale (IHDS), and the computerized Cambridge Neuropsychological Test Automated Battery (CANTAB), which evaluates psychomotor speed, sustained attention, visual memory, and emotion recognition. The results indicated that 66.7% of participants exhibited partial dependence in instrumental activities of daily living. Screening with the IHDS identified positive HAND screening in 96.7% of the sample. Performance on the CANTAB tasks revealed impairments primarily in memory, attention, and psychomotor speed, as well as difficulties in facial emotion recognition. Additionally, a significant association was observed between cognitive performance and functional capacity in everyday activities. These findings suggest that neurocognitive deficits remain prevalent among PLHIV even during antiretroviral therapy, highlighting the importance of systematic neuropsychological assessment in the clinical monitoring of this population.