Profile of Neurocognitive Impairment in Individuals Coinfected with Human Immunodeficiency Virus and Hepatitis C Virus: Meta-analysis and Meta-regression

Abstract

HIV and HCV are neurotrophic viruses with great potential to cause neurocognitive impairments (NCI). Yet, results of neuro studies among Coinfected individuals are still inconclusive. This study pooled estimates to define the neurocognitive profile and neuroepidemiology of Coinfection in relation to monoinfection. Data from the qualified studies was grouped in to seven neurologic domains to yield weighted average effect sizes (WAES) which were pooled together in meta-analyses. Further assessments were meta-regression analysis, sensitivity analysis and computation of heterogeneity diagnostic indices. From eleven studies the pooled estimates showed that only the Coinfected group had a medium effect size (ES) in speed of information processing (SIP). Other neurologic domains exhibiting a medium ES across all the study groups were executive function (EF) and attention/working memory. These neurocognitive deficits epidemiologically translates in to NCI prevalence of 47% among Coinfected group who were also twice more likely to be neurocognitively impaired compared to HIV monoinfection group. Despite substantial heterogeneity, Kernel density plot of WAES approximates to normal distribution making publication bias unlikely. Coinfection is associated with deficit in SIP, EF and attention/working memory with substantial risk of global NCI underscoring the need for medical and psychosocial interventions to improve the lives of affected individuals.