Mode Of HIV Exposure and Its Role in The Excess Risk of Neurocognitive Impairment in People Living With HIV: a protocol for systematic review and meta-analysis of case-controlled studies

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Abstract

Abstract Background People living with HIV (PLHIV) are at a higher risk of neurocognitive impairment (NI), more prominently in those who delay HIV treatment. Combined antiretroviral treatment (cART) though has been known to be effective in reducing morbidity and mortality, is not yet optimal in controlling NI. Studies have proposed theories explaining the risks, aetiology, and pathogenesis associated with neurocognitive problems of PLHIV and there were different cognitive domains impaired in PLHIV than in those without the infection, in which method of HIV exposure (MoHE) may have a role. This proposed meta-analysis aims at evaluating the excess risk of NI in PLHIV concerning the mode of HIV exposure. Methods This protocol was developed following The Preferred Reporting Items for Systematic reviews and Meta-analysis (PRISMA) guidelines and registered in PROSPERO 2021 (CRD42021271358). Literature searches will be conducted in the following electronic databases: Medline (OVID), Embase (OVID), PsycInfo (OVID), Web of Science, ProQuest, as well as OpenGrey and clinical trial databases to identify records relevant to our search terms, published from 1 January 2007 up to 31 May 2021, followed by hand-search of the reference of each selected article. We will include observational cross-sectional or cohort studies examining adolescents (12 years or older) and adults (18 years or older) reporting the proportion of NI. The exposure is HIV diagnosis or documented HIV status at study enrolment. The comparator is HIV negatives age 12 years or older, with contemporaneous study enrolment as the exposed group. The Newcastle Ottawa Scale (NOS) will be applied to assess each selected study's possible risk of bias. The primary outcome will be the number of participants diagnosed with NI by the MoHE in seropositive and seronegative groups. Discussion The evidence gathered from the selected studies will be discussed to provide insight into the risk of NI by different MoHE. Despite the significant decrease in the number of HIV related dementia, mild NI cases are still numerous. The MoHE may contribute to cognitive problems, considering different HIV exposures can be associated with specific NI risk factors. However, it is currently unknown whether the MoHE can alter the risk of NI. Systematic review registration: PROSPERO 2021 (CRD42021271358)

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last seen: 2026-05-19T01:45:01.086888+00:00