To determine the prevalence of and factors associated with neurocognitive impairment (NCI) among older Peruvians with HIV.

With increasing use of antiretroviral medications, people with HIV are living to geriatric ages increasing the risk of developing NCI. The Peruvian population over age 60 is expected to increase to 25% by 2050. Thus the problem of aging and dementia especially in HIV is pressing, but prevalence of HIV-associated NCI in Peru remains unknown.

We recruited 118 Peruvians with HIV over age 40 in central Lima from September to December 2019, collected sociodemographic and medical/psychiatric comorbidity data, and administered a brief neuropsychological battery assessing cognitive domains affected in HIV-associated NCI. Descriptive statistics and logistic regression analyses were performed.

Mean age was 51+/-8 years, 16.5% females and mean years of education was 14+/-3. Median (IQR) current absolute CD4 and nadir CD4 was 540 (352, 731) and 155 (75, 281), respectively. Mean duration of HIV infection was 10+/- 7 years and half (53%) had a detectable plasma viral load. RPR was positive in 29%, all received treatment; Hepatitis B surface antigen was positive in 14%; 9.7% had positive acid-fast bacillus testing all of which were treated. Mean T-scores demonstrated impairment in immediate/delayed recall (43) and working memory (37)  domains using demographically-adjusted norms. Older age was predictive of impairment in delayed recall (p=0.036) and motor skills (p=0.007); sex and all co-infections studied were not related to NCI.

Older Peruvians with HIV were found to be impaired in delayed recall and motor skills, worsened by older age, but not associated with common HIV co-infections. Further work is required with comparison to an demographically-matched control group. This is the first step in generating awareness of the gap in dementia and geriatric care among those living with HIV in Peru.