Neuropsychological deficits in human immunodeficiency virus type 1 clade C–seropositive adults from South India

Gupta, Jayashree Das; Satishchandra, Parthasarathy; Kumarpillai, Gopukumar; Wilkie, Frances L.; Waldrop‐Valverde, Drenna; Ellis, Ronald J.; Ownby, Raymond L.; Dk, Subbakrishna; Desai, Anita; Kamat, Anupa; Ravi, Vasanthapuram; Rao, B.S. Shankaranarayana; Satish, K.S.; Kumar, Mahendra

doi:10.1080/13550280701258407

Cited by 99 publications

(81 citation statements)

References 30 publications

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“…One study from South India documented cognitive dysfunction in about 60.5% of HIV subjects. [28] Prevalence of AIDS dementia is however lower among Indian (approx. 2%) is much lower than Americans ( 15-30%).…”

Section: Incidence Of Dementia In Indiamentioning

confidence: 99%

Dementia: Indian scenario

2012

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As per the estimates of the World Health Organization, aging population is increasing in developing countries and dementia is going to become epidemic among elderly in the coming decades. This demands early action to prevent the disease and treatment of the affected persons, which is poorly existent in middle- and low-income countries. The need of the hour to tackle dementia in India is to estimate disease burden in the community, search for risk and protective factors of dementia, and undertake measures to provide social benefits to the sufferers and those who are at risk. Raising awareness among the public and general physicians is an important task ahead. In India, there is lack of good longitudinal studies which can provide true trend of the disease and determine risk factors, paucity of basic and clinical researches on dementia, poor awareness, and inadequate availability of social benefit. India, being a country of diverse ethnicity and cultures, has great advantages to carry out genetic epidemiological study. The information may be useful for undertaking remedial measure. This article will highlight the existing state of the above medical and social issues and deficiencies, so that the stakeholders can make adequate preparation to provide relief to the dementia patients and those who are at risk. It is expected that the medical and scientific community will draw attention to the medical problem with the help of governmental and non-governmental agencies, and the political leadership will be motivated to undertake the issue of providing socioeconomic benefit to families of the victims.

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Section: Incidence Of Dementia In Indiamentioning

confidence: 99%

Dementia: Indian scenario

2012

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“…However, these laboratory studies did not examine cognitive status among patients and therefore the true functional significance of the Tat defect remains unclear. Furthermore, a study of 119 HIV positive individuals in India (Gupta et al 2007) suggested that HAND in clade C may be as common as in individuals infected with clade B. Whether or not more severe HANDs in the form of HIV-D are common among patients with clade C remains unclear.…”

Section: Introductionmentioning

confidence: 97%

Clinical Correlates of HIV-Associated Neurocognitive Disorders in South Africa

et al. 2009

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Human immunodeficiency virus-associated neurocognitive disorders (HAND) occurs globally and across different genetic clades of the virus. However, few studies have examined HAND in South Africa, despite the prevalence of HIV in this region of the world, and the predominance of clade C. The present study examined the relationship between a number of demographic and clinical variables in a sample of 536 patients attending HIV clinics in South Africa. HAND was present in 23.5% of the sample and was associated with older age, a low educational level among those with post-traumatic stress disorder (PTSD) and alcohol abuse among those with many months since diagnosis. These results suggest that HAND is common among patients in South Africa, and is associated with clinical variables such as PTSD and alcohol abuse. This underlines the impact of HIV on the nervous system and the importance of screening for co morbid mental health conditions.

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“…Previous local studies had identified older age and lower baseline CD4 counts as predictors of progression to AIDS9 and that the commonest AIDS-defining illnesses between 1985 and 2001 did not involve the central nervous system 10. Despite a previous study in South India that found mild-to-moderate neuropsychological deficits in a functionally normal HIV-positive group,11 yet the total burden of HAND in Singapore and other South Asian HIV-positive populations and its clinical significance is so far unknown.…”

Section: Introductionmentioning

confidence: 98%

HIV-associated neurocognitive disorders (HAND) in a South Asian population - contextual application of the 2007 criteria

2012

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ObjectivesTo estimate the prevalence of HIV-associated neurocognitive disorders (HAND) among HIV patients in a multiethnic South Asian population, describe the pattern of neurocognitive impairment in HAND and the factors associated with HAND.DesignA cross-sectional survey of HIV-positive outpatients and inpatients.SettingThe sole referral centre for HIV/AIDS treatment in Singapore.ParticipantsInclusion criteria were HIV positive, age between 21 and 80 years old and at least 3 years of education. Exclusion criteria included concomitant delirium, serious systemic disease or major psychiatric illness. 265 patients did not meet criteria or declined to participate. The final sample size was 132.Outcome measuresThe primary outcome measure was cognitive impairment based on performance on the Montreal Cognitive Assessment, International HIV Dementia Scale and Instrumental Activities of Daily Living. The secondary outcome measure was the classification of impairment based on the 2007 updated research nosology for HAND.ResultsThe prevalence of HAND was 22.7% of which 70% (15.9% of total) were asymptomatic neurocognitive impairment, 23.3% (5.3% of total) were mild neurocognitive disorder and 6.7% (1.5% of total) were HIV-associated dementia. Increasing age (OR 1.104, 95% CI 1.054 to 1.155, p<0.001), less education (OR 0.78, 95% CI 0.69 to 0.89, p<0.001) and low baseline CD4 count (OR 0.15, 95% CI 0.03 to 0.74, p=0.019) were associated with HAND. Delayed recall, language and abstract thinking were the domains most commonly affected, but impairment in visuospatial ability (RC 3.013, 95% CI 1.954 to 4.073, p<0.001) and attention (RC 2.205, 95% CI 1.043 to 3.367, p<0.001) were most strongly associated with HAND.ConclusionHAND is common among HIV patients in a South Asian sample, most of whom are asymptomatic. Older patients with less education and severe illness at diagnosis are at highest risk of HAND. Delayed recall is most commonly affected, but visuospatial dysfunction is most strongly associated with prevalent HAND.

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Neuropsychological deficits in human immunodeficiency virus type 1 clade C–seropositive adults from South India

Cited by 99 publications

References 30 publications

Dementia: Indian scenario

Dementia: Indian scenario

Clinical Correlates of HIV-Associated Neurocognitive Disorders in South Africa

HIV-associated neurocognitive disorders (HAND) in a South Asian population - contextual application of the 2007 criteria

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