Does Micro-albuminuria is a Predictive Factor for Cognitive Impairment in Persons Living With HIV (PLHIV) Who Achieve cART-sustained Immunovirological Control ?

Study Overview
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Brief Summary
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Chronic kidney disease (CKD), frequent in PLHIV, is a risk factor for cognitive impairment. Micro-albuminuria is an early manifestation of CKD and a marker of vascular risk, notably affecting the small vessels. In the older general population microalbuminuria is associated with greater annual cognitive decline and has been proposed as an easily and inexpensive measured marker predicting future cognitive function decline. Ageing of the PLH leads to an increase of cognitive disorders and chronic renal failure incidence and could imply a common underlying mechanism affecting the renal and cerebral microvasculature. In this setting the investigators undertake this prospective, cross-sectional, case-control study to determine whether the presence of a microalbuminuria at least 5 years ago in PLHs with sustained good combination antiretroviral therapy (cART)-controlled immunovirological parameters could be a marker predicting future cognitive impairment. They chose PLHs infected for at least 5 years and with cART-sustained immunovirological control for at least 1 year.

Official Title
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Does Micro-albuminuria is a Predictive Factor for Cognitive Impairment in Persons Living With HIV (PLHIV) Who Achieve cART-sustained Immunovirological Control ?

Conditions
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HIV

Intervention / Treatment
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* Behavioral: Cognitive function tests


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Known HIV infection for at least 5 years Undetectable viral load under antiretroviral (ARV) treatment for at least 1 year, regardless of the type of ARV Number of CD4 ≥ 350, regardless of the CD4 nadir Unopposed to participate to the study For cases - Micro-albuminuria defined by microalbuminuria / creatinuria between 3 and 30 mg/mmol For controls, matched for age +/- 5 years - Absence of microalbuminuria defined by microalbuminuria / creatinuria <3 mg/mmol Exclusion criteria Known neurological disease, active or former Active and regular use of drugs Active Chronic alcoholism Diabetes with known complications Renal failure with glomerular filtration rate <15 ml / min Micro-albuminuria / creatinuria> 30 mg / mmol HIVAN Unbalanced arterial hypertension Patient did not have dosing glucose and lipid levels in over a year Unaffiliated patient (or copyright holder) to a social security scheme People enjoying a measure of legal protection Pregnant or breastfeeding Secondary exclusion criteria - Neurological disease found during the assessment.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| PLHIV with microalbuminuria<br>Patient infected with HIV and well controlled by treatments, with microalbuminuria for at least 5 years | Behavioral: Cognitive function tests<br> <br> |
| PLHIV without microalbuminuria (control)<br>Patient infected with HIV and well controlled by treatments, without microalbuminuria, matched for age +/- 5 years | Behavioral: Cognitive function tests<br> <br> |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Z-Score of five neurocognitive domains tested and global deficit score | Comparisons of composite cognitive scores (z-score) and scores of global cognitive deficits (GDS) between the two populations. The neuropsychological tests are made during a single consultation of a half day. | 4 hours | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Cognitive impairment, HIV, Microalbuminuria, Chronic kidney disease