HIV- and AIDS-associated neurocognitive functioning in Zambia – a perspective based on differences between the genders

Abstract

Human immunodeficiency virus (HIV) infection and acquired immune deficiency syndrome (AIDS) are frequently associated with neurocognitive impairment (NCI). However, few studies have examined the interrelationship between gender and NCI in the HIV and AIDS population. This cross-sectional study examined the neurocognitive (NC) functioning of HIV-infected male and female adults from urban Zambia. The participants included 266 HIV seropositive (HIV+) adults (males [n=107] and females [n=159]). Participants completed NC assessment by means of a comprehensive test battery using normative data from 324 HIV-seronegative (HIV−) controls. The norms corrected for effects of age, education, and gender in the general population, and the test battery measures domains of attention/working memory (learning and delayed recall), executive function, verbal fluency, processing speed, verbal and visual episodic memory, and fine motor skills. An overall comparison of the HIV+ male and female participants yielded no statistically significant differences. Analysis of covariance results controlling for disease characteristics showed that HIV+ female participants had worse delayed recall scores than males, F(1,117) =9.70, P=0.002, partial η2=0.077. The females also evidenced a trend toward greater impairment on learning efficiency (P=0.015). The findings suggest that there are gender-related differences in NCI after controlling for disease characteristics. It was observed that although the HIV+ females enjoyed better health compared to their HIV+ male counterparts, they still had worse performance on the neuropsychological tests. This implies that HIV may have more NC consequences for Zambian females than males.

Differences in Neurocognitive Impairment Among HIV-Infected Latinos in the United States

“…In light of prior evidence showing greater NCI risk among HIV+ females than males (Kabuba, Menon, Franklin, Heaton & Hestad, 2016), it is worth noting that there was a higher percentage of females among Puerto Ricans than Mexicans. However, findings on the association between gender and HIV-associated NCI are inconsistent (Faílde-Garrido, Rodriguez Alvarez, & Simón-López, 2008; Heaton et al, 2011, 2014), and given our methodological approach, it is unlikely that NCI differences between Latino subgroups were accounted for by differential gender composition.…”

HIV-associated neurocognitive disorders at Moi teaching and referral hospital, Eldoret, Kenya

“…In the pathogenesis of HAND men have less immune activation of the macrophages, astrocytes and microglia hence less toxin signaling pathways that underlie the brain dysfunction in HAND. Most men in our African society are privileged to go to school and get educated while female play a role of doing house chores hence they have better cognitive reserve than women hence better cognitive performance [ 28 ].…”

Sex Differences in Select Non-communicable HIV-Associated Comorbidities: Exploring the Role of Systemic Immune Activation/Inflammation

“…In meta-regression analysis, there was no relationship between sex or age and neurocognitive impairment(65). By contrast, Kabuba et al published an important study suggesting that among PLHIV in Zambia, WLHIV performed worse on neuropsychological testing than did MLHIV even after controlling for HIV characteristics(66). …”