HIV-associated neurocognitive impairment in stable people living with HIV on ART in rural Tanzania.
HIV
antiretroviral treatment
neurocognitive impairment
prevalence
rural
sub-Saharan Africa
Journal
HIV medicine
ISSN: 1468-1293
Titre abrégé: HIV Med
Pays: England
ID NLM: 100897392
Informations de publication
Date de publication:
02 2021
02 2021
Historique:
accepted:
07
09
2020
pubmed:
16
11
2020
medline:
15
3
2022
entrez:
15
11
2020
Statut:
ppublish
Résumé
Few studies have assessed cognitive impairment among healthy people living with HIV (PLWH) who are stable on antiretroviral treatment (ART) in sub-Saharan Africa. We conducted a cross-sectional study among a random sample of stable adult PLWH from rural Tanzania on ART for more than 1 year and without immunological failure or pre-existing neurological disease. We evaluated the prevalence and risk factors for neurocognitive impairment (NCI), assessed through neuropsychological tests, functional and depression questionnaires and defined as a mean Z-score ≤ -1 in two or more cognitive domains. Among 243 participants [median age = 44.3 years (interquartile range: 36-52] and 71% female] we found a rate of NCI of 19.3% (95% confidence interval: 14.8-24.8%). Memory and psychomotor domains demonstrated the highest impairment. Independent predictors of NCI were age and self-reported alcohol use. Other classical risk factors were not associated with HIV-associated NCI. Despite effective ART roll-out, NCI remained a prevalent condition in this healthy rural Tanzanian population of PLWH on ART. Age and alcohol use were key risk factors.
Substances chimiques
Anti-Retroviral Agents
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
102-112Informations de copyright
© 2020 British HIV Association.
Références
Heaton RK, Franklin DR, Ellis RJ et al. HIV-associated neurocognitive disorders before and during the era of combination antiretroviral therapy: differences in rates, nature, and predictors. J Neurovirol 2011; 17 (1): 3-16.
Maki PM, Rubin LH, Valcour V et al. Cognitive function in women with HIV: findings from the women’s interagency HIV study. Neurology 2015; 84 (3): 231-240.
Bonnet F, Amieva H, Marquant F et al. Cognitive disorders in HIV-infected patients: are they HIV-related? AIDS 2013; 27 (3): 391-400.
Sanmarti M, Ibáñez L, Huertas S et al. HIV-associated neurocognitive disorders. J Mol Psychiatry 2014; 2 (1): 2.
Sacktor N, Skolasky RL, Seaberg E et al. Prevalence of HIV-associated neurocognitive disorders in the Multicenter AIDS Cohort Study. Neurology 2016; 86: 334-340.
WHO. Number of people (all ages) living with HIV Estimates by WHO region. 2013. Available at http://apps.who.int/gho/data/view.main.22100WHO?lang=en (Accessed 15 August 2019).
Habib AG, Yakasai AM, Owolabi LF et al. Neurocognitive impairment in HIV-1-infected adults in Sub-Saharan Africa: a systematic review and meta-analysis. Int J Infect Dis 2013; 17 (10): e820-e831.
Holguin A, Banda M, Willen EJ et al. HIV-1 effects on neuropsychological performance in a resource-limited country, Zambia. AIDS Behav 2011; 15 (8): 1895-1901.
Sacktor NC, Wong M, Nakasujja N et al. The International HIV Dementia scale: a new rapid screening test for HIV dementia. AIDS. 2005; 19: 1367-1374.
Robertson K, Jiang H, Evans SR et al. International neurocognitive normative study: neurocognitive comparison data in diverse resource-limited settings: AIDS Clinical Trials Group A5271. J Neurovirol. 2016; 22 (4): 472-478.
Antinori A, Arendt G, Becker JT et al. Updated research nosology for HIV-associated neurocognitive disorders. Neurology 2007;69 (18): 1789-1799.
Yusuf AJ, Hassan A, Mamman AI, Muktar HM, Suleiman AM, Baiyewu O. Prevalence of HIV-associated neurocognitive disorder (HAND) among patients attending a tertiary health facility in Northern Nigeria. J Int Assoc Provid AIDS Care 2017; 16 (1): 48-55.
Kabuba N, Anitha Menon J, Franklin DR, Heaton RK, Hestad KA. Use of Western Neuropsychological Test Battery in Detecting HIV-Associated Neurocognitive Disorders (HAND) in Zambia. AIDS Behav 2017;21 (6):1717-1727.
Carey CL, Woods SP, Gonzalez R et al. Predictive validity of global deficit scores in detecting neuropsychological impairment in HIV infection. J Clin Exp Neuropsychol 2004; 26 (3): 307-319.
Yakasai AM, Gudaji MI, Muhammad H et al. Prevalence and Correlates of HIV-Associated Neurocognitive Disorders (HAND) in Northwestern Nigeria. Neurol Res Int 2015; 2015: 486960.
Kelly CM, van Oosterhout JJ, Ngwalo C et al. HIV associated neurocognitive disorders (HAND) in Malawian adults and effect on adherence to combination anti-retroviral therapy: a cross sectional study. PLoS ONE 2014; 9 (6): e98962.
Atashili J, Gaynes BN, Pence BW et al. Prevalence, characteristics and correlates of a positive-dementia screen in patients on antiretroviral therapy in Bamenda, Cameroon: a cross-sectional study. BMC Neurol 2013; 13: 86.
Ganasen KA, Fincham D, Smit J, Seedat S, Stein D. Utility of the HIV Dementia Scale (HDS) in identifying HIV dementia in a South African sample. J Neurol Sci 2008; 269 (1-2): 62-64.
Kwasa J, Cettomai D, Lwanya E et al. Lessons learned developing a diagnostic tool for HIV-associated dementia feasible to implement in resource-limited settings: pilot testing in Kenya. PLoS ONE 2012; 7 (3): e32898.
Royal W, Cherner M, Carr J et al. Clinical features and preliminary studies of virological correlates of neurocognitive impairment among HIV-infected individuals in Nigeria. J Neurovirol 2012; 18 (3): 191-199.
Breuer E, Stoloff K, Myer L, Seedat S, Stein D, Joska J. Reliability of the lay adherence counsellor administered substance abuse and mental illness symptoms screener (SAMISS) and the International HIV Dementia Scale (IHDS) in a Primary care HIV Clinic in Cape Town, South Africa. AIDS Behav 2012; 16 (6): 1464-1471.
Lawler K, Jeremiah K, Mosepele M et al. Neurobehavioral effects in HIV-positive individuals receiving highly active antiretroviral therapy (HAART) in Gaborone, Botswana. PLoS ONE 2011; 6 (2): e17233.
Robbins RN, Remien RH, Mellins CA, Joska JA, Stein DJ. Screening for HIV-associated dementia in South Africa: potentials and pitfalls of task-shifting. AIDS Patient Care STDS [Internet]. 2011; 25 (10): 587-593.
Birbeck GL, Kvalsund MP, Byers PA et al. Neuropsychiatric and socioeconomic status impact antiretroviral adherence and mortality in rural Zambia. Am J Trop Med Hyg [Internet] 2011; 85 (4): 782-789.
Lawler K, Mosepele M, Ratcliffe S et al. Neurocognitive impairment among HIV-positive individuals in Botswana: a pilot study. J Int AIDS Soc 2010; 13 (1): 1-9.
Nakasujja N, Skolasky RL, Musisi S et al. Depression symptoms and cognitive function among individuals with advanced HIV infection initiating HAART in Uganda. BMC Psychiatry [Internet] 2010; 10 (1): 44.
Salawu FK, Bwala SA, Wakil MA, Bani B, Bukbuk DN, Kida I. Cognitive function in HIV-seropositive Nigerians without AIDS. J Neurol Sci 2008; 267 (1-2): 142-146.
Hendrie C, Hall S, Ph D et al. Prevalence in Two Communities: of Alzheimer’s Nigerian Disease Africans and Dementia and African Americans. Am J Psychiatry 1995; 152 (10): 1485-1492.
Wong MH, Robertson K, Nakasujja N et al. Frequency of and risk factors for HIV dementia in an HIV clinic in sub-Saharan Africa. Neurology 2007; 68 (5): 350-355.
Vinters HV. The AIDS dementia complex. Ann Neurol 1987; 21 (6): 612.
McCutchan Ja, Marquie-Beck Ja, FitzSimons Ca et al. Role of obesity, metabolic variables, and diabetes in HIV-associated neurocognitive disorder. Neurology 2012; 78 (7): 485-492.
Valcour VG, Kiweewa F, Namagembe R et al. Predictors of Cognitive Performance Among HIV-Infected Patients in East Africa. Conference on Retroviruses and Opportunistic Infections (CROI). Seattle, February 2015.
Letang E, Kalinjuma AV, Glass TR et al. Cohort profile: The Kilombero and Ulanga Antiretroviral Cohort (KIULARCO) - A prospective HIV cohort in rural Tanzania. Swiss Med Wkly 2017; 147: 1-9.
HIV/AIDS Programme. HIV/AIDS programme strengthening health services to fight HIV/AIDS AntiretrovirAl therApy for hiv infection in Adults And Adolescents. Recommendations for a public health approach. 2010 Revision. Heal San Fr 2010; 4911 (866):1-144.
Mor V, Laliberte L, Morris JN, Wiemann M. The Karnofsky performance status scale: an examination of its reliability and validity in a research setting. Cancer 1984; 53 (9): 2002-2007.
Lawton MP, Brody EM. Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist 1969; 9 (3): 179-186.
Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med 2001; 16 (9): 606-613.
Maj M, D’Elia L, Satz P et al. Evaluation of two new neuropsycho- logical tests designed to minimize cultural bias in the assess- ment of HIV-1 seropositive persons: a WHO study. Arch Clin Neuropsychol 1993; 8 (2): 123-135.
Maj M, Satz P, Janssen R et al. WHO Neuropsychiat- ric AIDS study, cross-sectional phase II. Neuropsychological and neurological findings. Arch Gen Psychiatry 1994; 51 (1): 51-61.
Sheridan LK, Fitzgerald HE, Adams KM et al. Normative symbol digit modalities test performance in a community-based sample. Arch Clin Neuropsychol 2006; 21 (1): 23-28.
Lafayette Instrument. Grooved Pegboard User’s Manual. Lafayette, IN: Lafayette Instrument Company, Inc., 2003. http://www.limef.com/downloads/MAN-32025-forpdf-rev0.pdf.
WHO. ICD-10: International Statistical Classification of Diseases and Related Health Problems. 10th revision [Internet]. 2010. Available at http://apps.who.int/classifications/icd10/browse/2010/en (Accessed 15 August 2019).
Robertson K, Nakigozi G, Anok Aet al. Neurocognitive Performance and Normative Comparison Data in HIV+ and HIV-Individuals in Rakai, Uganda. International AIDS Conference Durban, South Africa, July 2016. Available at http://www.natap.org/2016/IAC/IAC_112.htm.
Sacktor N, Saylor D, Nakigozi G et al. Effect of HIV Subtype and Antiretroviral therapy on HIV- associated neurocognitive disorder (HAND) stage in Rakai, Uganda. J Acquir Immune Defic Syndr 2019; 81 (2): 216-223.
Meyer A-CL, Boscardin WJ, Kwasa JK, Price RW. Is it time to rethink how neuropsychological tests are used to diagnose mild forms of HIV-associated neurocognitive disorders? Impact of false-positive rates on prevalence and power. Neuroepidemiology 2013; 41 (3-4): 208-216.
Glass TR, Sterne JAC, Schneider MP et al. Self-reported nonadherence to antiretroviral therapy as a predictor of viral failure and mortality. AIDS 2015; 29 (16): 2195-2200.
Njamnshi AK, Zoung-Kanyi Bissek AC, Ongolo-Zogo P et al. Risk factors for HIV-associated neurocognitive disorders (HAND) in sub-Saharan Africa: the case of Yaoundé-Cameroon. J Neurol Sci 2009; 285 (1-2): 149-153.
Bottiggi KA, Chang JJ, Schmitt FA et al. The HIV Dementia scale: predictive power in mild dementia and HAART. J Neurol Sci 2007; 260 (1-2): 11-15.
Sacktor N, Nakasujja N, Skolasky RL et al. Benefits and risks of stavudine therapy for HIV-associated neurologic complications in Uganda. Neurology 2009; 72 (2): 165-170.
Singh D, Joska JA, Goodkin K et al. Normative scores for a brief neuropsychological battery for the detection of HIV-associated neurocognitive disorder (HAND) among South Africans. BMC Res Notes 2010; 3: 28.
Douglas-Newman KR, Smith RV, Spiers MV, Pond T, Kranzler HR. Effects of recent alcohol consumption level on neurocognitive performance in HIV+ individuals. Addict Disord their Treat. 2017; 16 (3): 95-107.
Joska JA, Westgarth-Taylor J, Hoare J et al. Neuropsychological outcomes in adults commencing highly active anti-retroviral treatment in South Africa: a prospective study. BMC Infect Dis 2012; 12 (1): 39.
Brown LAM, Jin J, Ferrell D et al. Efavirenz promotes β-secretase expression and increased Aβ1-40,42 via oxidative stress and reduced microglial phagocytosis: implications for HIV associated neurocognitive disorders (HAND). PLoS ONE 2014; 9 (4): e95500.
Ciccarelli N, Fabbiani M, Di Giambenedetto S et al. Efavirenz associated with cognitive disorders in otherwise asymptomatic HIV-infected patients. Neurology 2011; 76 (16): 1403-1409.
Robertson KR, Nakasujja N, Wong M et al. Pattern of neuropsychological performance among HIV positive patients in Uganda. BMC Neurol 2007; 7: 8.
https://www.indexmundi.com/factbook/compare/uganda.tanzania (Accessed 15 July 2019). 2018.
Sacktor N, Nakasujja N, Skolasky RL et al. HIV subtype D is associated with dementia, compared with subtype A, in immunosuppressed individuals at risk of cognitive impairment in Kampala, Uganda. Clin Infect Dis 2009; 49 (5): 780-786.
Muñoz-Moreno JA, Pérez-Álvarez N, Muñoz-Murillo A et al. Classification models for neurocognitive impairment in HIV infection based on demographic and clinical variables. PLoS ONE 2014; 9 (9): e107625.
Heaton RK, Marcotte TD, Mindt MR et al. The impact of HIV-associated neuropsychological impairment on everyday functioning. J Int Neuropsychol Soc 2004; 10 (3): 317-331.