BACKGROUND: Highly active antiretroviral therapy (HAART) can improve cognitive performance in some patients with HIV-associated cognitive impairment in the United States. The effect of HAART on HIV dementia in sub-Saharan Africa is largely unknown. OBJECTIVE: To evaluate neuropsychological test and functional performance in HIV+ individuals after 3 and 6 months of HAART in Uganda. METHODS: Twenty-three HIV+ individuals receiving HAART also received a detailed clinical history, neuropsychological testing, and a functional assessment. Follow-up evaluations were performed at 3 and 6 months after baseline. Longitudinal changes in the HIV dementia stage, the mean Z score for each neuropsychological test, and the Karnofsky Functional Performance Scale were evaluated at 3 and 6 months. RESULTS: The mean (SD) CD4 cell count improved from 71 (15) at baseline to 161 (30) at 3 months (p = 0.005) and 222 (46) at 6 months (p < 0.001). Improvements were found in the Memorial Sloan Kettering HIV dementia stage and in tests of verbal memory, psychomotor speed, and executive functioning after 3 and 6 months of HAART (p < 0.001 at 6 months for each neuropsychological test). There was also improvement in the Karnofsky Functional Performance Scale at both 3 and 6 months after the initiation of HAART (p < 0.001). CONCLUSION: Highly active antiretroviral therapy (HAART) can be associated with improvement in neurocognitive and functional performance in HIV+ individuals in sub-Saharan Africa. These results suggest that HAART, if available in areas with limited resources in sub-Saharan Africa, should be provided for patients with HIV-associated cognitive impairment.
BACKGROUND: Highly active antiretroviral therapy (HAART) can improve cognitive performance in some patients with HIV-associated cognitive impairment in the United States. The effect of HAART on HIV dementia in sub-Saharan Africa is largely unknown. OBJECTIVE: To evaluate neuropsychological test and functional performance in HIV+ individuals after 3 and 6 months of HAART in Uganda. METHODS: Twenty-three HIV+ individuals receiving HAART also received a detailed clinical history, neuropsychological testing, and a functional assessment. Follow-up evaluations were performed at 3 and 6 months after baseline. Longitudinal changes in the HIV dementia stage, the mean Z score for each neuropsychological test, and the Karnofsky Functional Performance Scale were evaluated at 3 and 6 months. RESULTS: The mean (SD) CD4 cell count improved from 71 (15) at baseline to 161 (30) at 3 months (p = 0.005) and 222 (46) at 6 months (p < 0.001). Improvements were found in the Memorial Sloan Kettering HIV dementia stage and in tests of verbal memory, psychomotor speed, and executive functioning after 3 and 6 months of HAART (p < 0.001 at 6 months for each neuropsychological test). There was also improvement in the Karnofsky Functional Performance Scale at both 3 and 6 months after the initiation of HAART (p < 0.001). CONCLUSION: Highly active antiretroviral therapy (HAART) can be associated with improvement in neurocognitive and functional performance in HIV+ individuals in sub-Saharan Africa. These results suggest that HAART, if available in areas with limited resources in sub-Saharan Africa, should be provided for patients with HIV-associated cognitive impairment.
Authors: Renee Donahue Carlson; Melissa A Rolfes; Kate E Birkenkamp; Noeline Nakasujja; Radha Rajasingham; David B Meya; David R Boulware Journal: Metab Brain Dis Date: 2014-01-09 Impact factor: 3.584
Authors: Kevin R Robertson; Hongyu Jiang; Johnstone Kumwenda; Khuanchai Supparatpinyo; Christina M Marra; Baiba Berzins; James Hakim; Ned Sacktor; Thomas B Campbell; Jeffrey Schouten; Katie Mollan; Srikanth Tripathy; Nagalingeswaran Kumarasamy; Alberto La Rosa; Breno Santos; Marcus T Silva; Cecilia Kanyama; Cindy Firhnhaber; Robert Murphy; Colin Hall; Cheryl Marcus; Linda Naini; Reena Masih; Mina C Hosseinipour; Rosie Mngqibisa; Sharlaa Badal-Faesen; Sarah Yosief; Alyssa Vecchio; Apsara Nair Journal: Clin Infect Dis Date: 2019-05-02 Impact factor: 9.079
Authors: Kevin Robertson; Kathy Kopnisky; James Hakim; Concepta Merry; Noeline Nakasujja; Colin Hall; Moussa Traore; Ned Sacktor; David Clifford; Charles Newton; Annelies Van Rie; Penny Holding; Janice Clements; Christine Zink; Jens Mielk; Mina Hosseinipour; Umesh Lalloo; Farida AMod; Christina Marra; Scott Evans; Jeff Liner Journal: J Neurovirol Date: 2008-04 Impact factor: 2.643
Authors: Eva M Müller-Oehring; Tilman Schulte; Margaret J Rosenbloom; Adolf Pfefferbaum; Edith V Sullivan Journal: Neuropsychologia Date: 2009-12-16 Impact factor: 3.139
Authors: Robert K Heaton; Lucette A Cysique; Hua Jin; Chuan Shi; Xin Yu; Scott Letendre; Donald R Franklin; Christopher Ake; Ofilio Vigil; J Hampton Atkinson; Thomas D Marcotte; Igor Grant; Zunyou Wu Journal: J Neurovirol Date: 2008-11 Impact factor: 2.643