Neurocognitive dysfunction among HIV positive patients using International HIV dementia scale

Achappa, Basavaprabhu; Priyadarshni, Shivani; Madi, Deepak; Unnikrishnan, Bhaskaran; Ramapuram, John T; Rao, Satish; Chowta, Mukta N; Mahalingam, Soundarya

doi:10.3126/ajms.v5i4.8724

Cited by 13 publications

(28 citation statements)

References 17 publications

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“…As compared to prior studies, the current finding is similar with the result of a study conducted in India (32.5%) (18), a study done in Nigeria (34.4%) [28] and an earlier Metaanalysis (systemic review) in Sub-Saharan area (30.9%) (2). However, it is less than the findings of previous studies undertaken in Botswana (38%) (21), a study in the international community (37%) (15), a study done in Cameroon (85%) [29], a study conducted in Asia (90%) (19) and a Ugandan study (46.49%) (30,31,32). …”

Section: Discussionmentioning

confidence: 78%

“…The problem of NCD in sub-Saharan area ranges from 20% – 37% as reported in prior studies (2,11,13). A report in the multi-center international studies that were conducted in Thailand, Zaire, Kenya, Brazil and Germany revealed that the neuropsychological deficit among HIV-positive people ranged from 13% in Brazil to 19% in Zaire (14,15,16).…”

Section: Introductionmentioning

confidence: 78%

“…Previous studies in India, Nigeria and Malawi found that symptomatic neurocognitive deficits were found in 2.5%, 9% and 12% of the participants respectively (17,18,20). The more likely reason behind impaired daily functioning among HIV-positive people is NCD since it can impair motor activity besides memory and cognitive function (4,11). …”

Section: Discussionmentioning

confidence: 99%

“…Deficits in different areas of life such as cognitive, motor, emotional and even personality changes can be caused by HIV especially lately as the disease progression fastens. These problems range from the asymptomatic impairments to mild forms and to the more severe HIV dementia (3,4,9,10,11). …”

Section: Introductionmentioning

confidence: 99%

“…The prevalence of HIV associated neurocognitive deficit (HAND) was 90%. And it was determined by IHDS (19). …”

Section: Introductionmentioning

confidence: 99%

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Prevalence of HIV associated neurocognitive deficit among HIV positive people in Ethiopia: a cross sectional study at Ayder Referral Hospital

Belete¹,

Medfu²,

Yemiyamrew³

2017

Ethiop J Health Sci

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BACKGROUND: HIV associated neurocognitive deficit impairs motor activity, neuropsychiatric functioning, daily activity and work activity usually due to the immune suppression effect of the virus. Sub-Saharan region including Ethiopia is the region with the highest burden of HIV. However, a few studies are found on this aspect nationally. This study was aimed at determining the prevalence and the factors associated with cognitive impairment among HIV positive people in Ethiopia who attended Ayder Comprehensive Specialized Hospital. METHOD: A hospital based cross sectional study was employed on 234 participants selected using systematic random sampling technique. Data was collected thrpugh face-to-face interview, observation and document review. International HIV dementia scale, activity of daily living scale and Hospital Anxiety and Depression scale were used to assess neuro cognitive deficit, activity of daily living, anxiety and depression respectively. The data was analyzed by using SPSS window 20. RESULT: About 88% of the subjects were receiving highly active antiretroviral therapy. The magnitude of Neuro cognitive deficit was 33.3% (95% CI; 27.7% -40.6%). Impairment in the activity of daily living was observed on 9.8% of the participants. Besides, 55.6% and 67.1% had anxiety and depressive disorders respectively. Late clinical stage of the illness (AOR= 4.2 (95% CI; 1.19, 14.44)) and impairment in the activity of daily living were significantly associated with neurocognitive deficit (AOR= 7.19 (95% CI; 1.73, 21.83). CONCLUSION: A higher prevalence of neurocognitive deficit was observed that was related to impaired activity of daily living and being in late stages of the illness. Hence, this should be a strong alarm for early detection of the problem and consistent review of the treatment regimen.

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Section: Discussionmentioning

confidence: 78%

Section: Introductionmentioning

confidence: 78%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…The prevalence of HIV associated neurocognitive deficit (HAND) was 90%. And it was determined by IHDS (19). …”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Prevalence of HIV associated neurocognitive deficit among HIV positive people in Ethiopia: a cross sectional study at Ayder Referral Hospital

Belete¹,

Medfu²,

Yemiyamrew³

2017

Ethiop J Health Sci

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Effect of human immunodeficiency virus on the brain: A review

Cilliers

Muller

2020

The Anatomical Record

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Thirty million people are infected with human immunodeficiency virus (HIV) worldwide, and HIV-associated neurocognitive disorder (HAND) is one of the most common comorbidities of HIV. However, the effect of HIV on the brain has not been fully investigated. This article aimed to review the changes to the brain due to HIV in terms of atrophy, diffusion changes, and hyperintensities.Studies have observed significant atrophy in subcortical gray matter, as well as in cortical white and gray matter. Moreover, the ventricles enlarge, and the sulci widen. Although HIV causes changes to the white and gray matter of the

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A Meta-Analytic Review of the Effect of Antiretroviral Therapy on Neurocognitive Outcomes in Adults Living with HIV-1 in Low-and Middle-Income Countries

et al. 2021

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HIV-associated neurocognitive impairment remains a challenge even in the era of antiretroviral therapy (ART). Over 90% of people living with HIV are in low-and middle-income countries. Hence, it is not surprising that such countries bear a considerable burden of comorbidities like HIV-associated neurocognitive impairment despite an overall increase in life expectancy. The literature suggests differences in patient characteristics, clinical profile, prevalent HIV subtypes, treatment choices, pharmacogenetics, and socioeconomic factors between low-and middle-income countries compared with highincome countries. Therefore, we aimed to evaluate the effect of ART on neurocognitive outcomes in low-and middle-income countries. A comprehensive search of five databases (PubMed, CINAHL, CENTRAL, PsychInfo, Google scholar) for studies published between 1996 to 2020 was performed to identify studies that reported neurocognitive outcomes in ART-treated and ART naïve HIV positive individuals. Two independent reviewers conducted study screening, data extraction, and evaluation of the risk of bias. Pooled effect size estimates (Hedges' g) and 95% CI were computed using random-effects models. Sensitivity analysis, subgroup analysis, meta-regression, and evaluation of publication bias were also conducted. Forty studies (24 cross-sectional, 13 longitudinal studies, and two randomized controlled trials) contributed to a series of meta-analyses. We found significant small to moderate effects of antiretroviral therapy for global cognition (Hedges' g observed = 0.30; 95% CI: 0.15, 0.44; k = 25; p = 0.0003; I 2 = 92.1%; tau = 0.32; Q = 305.1), executive function (Hedges' g = 0.24, 95%CI: 0.02,0.46; p-0.04; k = 8; I 2 = 37.5%; tau = 0.23; Q = 11.2), and speed of information processing (Hedges' g = 0.25, 95% CI: 0.05, 0.45; k = 9; p = 0.02; I 2 = 86.4%; tau = 0.21; Q = 58.9). We found no significant ART effect on attention-working memory, learning and memory, motor function, and verbal fluency. No significant effect was seen with the duration of therapy, efavirenz use, and Central Penetrating Effectiveness (CPE) of antiretroviral therapy. Subgroup analyses identified study design (betweengroup and within-group; cross-sectional and longitudinal) and normative scores as significant sources of heterogeneity. Metaregression analysis indicated that nadir CD4 modified the magnitude of ART's effect on cognitive outcomes. Age, gender, and country income-group were not significant moderators. Our findings provide systematic evidence that antiretroviral therapy improves neurocognitive outcomes in the domains of global cognition, executive function and speed of information processing, of people living with HIV in low-and middle-income countries, especially those with advanced immunosuppression. However, these findings are not definitive as they are limited by the probability of publication bias, high heterogeneity, and exclusion of significant confounders. Prospero registration number: CRD42020203791.

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Neurocognitive dysfunction among HIV positive patients using International HIV dementia scale

Cited by 13 publications

References 17 publications

Prevalence of HIV associated neurocognitive deficit among HIV positive people in Ethiopia: a cross sectional study at Ayder Referral Hospital

Prevalence of HIV associated neurocognitive deficit among HIV positive people in Ethiopia: a cross sectional study at Ayder Referral Hospital

Effect of human immunodeficiency virus on the brain: A review

A Meta-Analytic Review of the Effect of Antiretroviral Therapy on Neurocognitive Outcomes in Adults Living with HIV-1 in Low-and Middle-Income Countries

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