Verbal communication in HIV patients: toward a description of clinical communication impairment profiles
V. Abusamra1,2, L. Abusamra3, B. Sampedro2, M. Guemes2, M. Macaya2, O. Sued3, A. Ferreres2,4
1University of Buenos Aires, Linguistic, Ciudad Autónoma de Buenos Aires, Argentina, 2Hospital Eva Perón, Neuropsychology, Buenos Aires, Argentina, 3Fundación Huésped, Infectious Diseases, Ciudad Autónoma de Buenos Aires, Argentina, 4University of Buenos Aires, Psychology, Ciudad Autónoma de Buenos Aires, Argentina
Background: The disruption of neurocognitive functioning is a frequent complication in HIV-positives patient. Deficits in communicative skills sometimes cause a significant disability in this population. Moreover, the clinical profiles of communication impairments in HIV patients, including their correlation with underlying cognitive deficits, are still unreported.The objectives of this research were: (1) to evaluate the proportion of patients with HIV that present verbal communication deficits by applying Protocol MEC; (2) to describe verbal communication impairment profiles in patients with HIV; and (3) to promote a better understanding of the difficulties these patients experience.
Methods: We evaluated 20 patients that met the following criteria for inclusion: over 18 years of age; HIV-positive; native speakers of Spanish; no alterations in language acquisition, reading, or writing; no history of neurological or psychiatric disease; patients with antiretroviral treatment (no efavirenz) with viral load > 50 copies/ml, and patients without treatment.
They were evaluated with Protocol MEC, which values verbal communication abilities, and with five neuropsychological tests that evaluate basic cognitive abilities (executive functions, attention, inhibition processes, and working memory).
Results: We compared patients' performances with the “alert points”. The results for each task were turned into score Z on the basis of Protocol MEC normative data. A hierarchic cluster analysis was carried out to identify subgroups with different profiles according to the areas that were affected. Five clusters were detected: CLUSTER 1: Pragmatic/discursive deficits; CLUSTER 2: Semantic/pragmatic deficits; CLUSTER 3: Semantic/ discursive deficits; CLUSTER 4: Wild deficits; CLUSTER 5: Heterogeneous alterations.
Conclusion: The detection of communication deficit profiles in HIV patients would be the starting point for the identification of disorders and the admission of the patients to health care system. This research constitutes an initial approach towards the identification of clinical profiles among HIV patients.
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