[Consensus statement on the clinical management of human immunodeficiency virus-associated neurocognitive disorders]. / Documento de consenso sobre el manejo clínico de los trastornos neurocognitivos asociados a la infección por el virus de la inmunodeficiencia humana (enero 2013).

OBJECTIVE: To develop a consensus document containing clinical recommendations for the management of human immunodeficiency virus (HIV)-associated neurocognitive disorder (HAND). METHODS: We assembled a panel of experts appointed by GeSIDA and the Secretariat of the National AIDS Plan (PNS), including internal medicine physicians with expertise in the field of HIV, neuropsychologists, neurologists and neuroradiologists. Scientific information was reviewed to October 2012 in publications and conference papers. In support of the recommendations using two levels of evidence: the strength of the recommendation in the opinion of the experts (A, B, C) and the level of empirical evidence (I, II, III), two levels based on the criteria of the Infectious Disease Society of America, already used in previous documents GeSIDA/SPNS. RESULTS: Multiple recommendations for the clinical management of these disorders are provided, including two graphics algorithms, considering both the diagnostic and possible therapeutic strategies. CONCLUSIONS: Neurocognitive disorders associated with HIV infection is currently highly prevalent, are associated with a decreased quality of life and daily activities, and given the possibility of occurrence of an increase in the coming years, there is a need to adequately manage these disorders, from a diagnostic as well as therapeutic point of view, and always from a multidisciplinary perspective.

[Neurocognitive disorders related to human immunodeficiency virus infection]. / Trastornos neurocognitivos en la infección por el virus de la inmunodeficiencia humana.

Disruption of neurocognitive functioning is one of most frequent complications in patients with HIV infection nowadays. The Highly Active Antiretroviral Therapy (HAART) has demonstrated an improvement associated with its use, although there are different works that show this improvement is achieved in a low proportion of individuals who initiate therapy. The most known characterization of neurocognitive dysfunction is the HIV-associated Dementia (HAD), yet there may also exist the asymptomatic neurocognitive impairment (ANI) or the Minor Cognitive-Motor Disorder (MCMD). This review describes the disorders related to HIV infection, and comments on possible interventions focused on the protection of neurocognitive functioning in HIV-infected people.

[Serological testing and prevalence of human immunodeficiency, hepatitis B and C viruses infections amongst acute psychiatric inpatients]. / Demanda de serologías y prevalencia de la infección por los virus de la inmunodeficiencia humana, hepatitis B y hepatitis C en pacientes psiquiátricos agudos hospitalizados.

BACKGROUND AND OBJECTIVE: The request for serological tests for HIV, HBV and HCV is usual amongst acute psychiatric inpatients. Nevertheless, the seroprevalence and the repercussion of a positive result have been scarcely studied. PATIENTS AND METHOD: Serological requests for these viruses were retrospectively analyzed in a sample of 332 psychiatric inpatients. RESULTS: Serological tests were requested by 65.3% patients. The prevalence of any seropositivity was 7.3%: 1.4% were infected by HIV-I, 3.2% had been in contact with HBV but none had an active infection, and 5.1% were infected by HCV. The presence of a positive result did not change the psychiatric therapeutic approach in any case. CONCLUSIONS: The low prevalence of seropositivity suggests that such tests should be performed selectively in patients who present risk factors or atypical psychiatric symptoms.

Trastornos neurocognitivos en la infección por el virus de la inmunodeficiencia humana / Neurocognitive disorders related to human immunodeficiency virus Infection

La afectación del funcionamiento neurocognitivo es una de las complicaciones más frecuentes en la infección por el virus de la inmunodeficiencia humana (VIH) en la actualidad. Los tratamientos antirretrovirales de gran actividad (TARGA [highly active antiretroviral therapy, o HAART]) han demostrado un beneficio asociado a su uso, pero existen diferentes trabajos que muestran cómo ese beneficio se observa en una baja proporción de personas que empiezan tratamiento. La forma más conocida de alteración neurocognitiva es la demencia asociada al VIH (HIV-associated dementia [HAD]). Sin embargo, también puede existir la alteración neurocognitiva subclínica (asymptomatic neurocognitive impairment [ANI]) o el trastorno cognitivo-motor leve (minor cognitive-motor disorder [MCMD]). Esta revisión describe esos trastornos asociados a la infección por el VIH, así como, por otro lado, también dedica una parte de discusión a posibles intervenciones centradas en la protección del funcionamiento neurocognitivo en las personas infectadas por el VIH (AU)

Disruption of neurocognitive functioning is one of most frequent complications in patients with HIV infection nowadays. The Highly Active Antiretroviral Therapy (HAART) has demonstrated an improvement associated with its use, although there are different works that show this improvement is achieved in a low proportion of individuals who initiate therapy. The most known characterization of neurocognitive dysfunction is the HIV-associated Dementia (HAD), yet there may also exist the asymptomatic neurocognitive impairment (ANI) or the Minor Cognitive-Motor Disorder (MCMD). This review describes the disorders related to HIV infection, and comments on possible interventions focused on the protection of neurocognitive functioning in HIV-infected people (AU)

Demanda de serologías y prevalencia de la infección por los virus de la inmunodeficiencia humana, hepatitis B y hepatitis C en pacientes psiquiátricos agudos hospitalizados / Serological testing and prevalence of human immunodeficiency, hepatitis B and C viruses infections amongst acute psychiatric inpatients

FUNDAMENTO Y OBJETIVO: La solicitud de pruebas serológicas para los VIH, VHB y VHC en los pacientes psiquiátricos que ingresan en unidades de agudos es una práctica frecuente, pero la seroprevalencia y las repercusiones de los resultados han sido escasamente estudiados. PACIENTES Y MÉTODO: Se evalúa de forma retrospectiva la petición de pruebas serológicas para estos virus en 332 pacientes con trastornos psiquiátricos agudos ingresados. RESULTADOS: Se solicitaron serologías para el 65,3 per cent de los pacientes. La prevalencia de alguna seropositividad fue del 7,3 per cent. El 1,4 per cent fue positivo para el VIH-1, el 3,2 per cent había tenido contacto con el VHB (ninguno presentaba infección activa), y el 5,1 per cent estaba infectado por el VHC. En ningún caso los resultados positivos repercutieron en el tratamiento psiquiátrico del paciente. CONCLUSIONES: La baja prevalencia de seropositividad indica que estas pruebas deberían ser solicitadas selectivamente en pacientes que presenten factores de riesgo o síntomas psiquiátricos atípicos (AU)