M Sanmartí1,2,3,4, A C Meyer5,6, A Jaen3,7, K Robertson8, N Tan9, H Mapesi10,11,12, L Samson10,13, R Ndaki10,13, M Battegay14,15, M Tanner11,12, M Weisser10,11,12, D Dalmau1,2,3,7, E Letang10,11,16,17. 1. Infectious Diseases & HIV Service, Hospital Universitari MutuaTerrassa, Terrassa, Spain. 2. University of Barcelona, Catalonia, Barcelona, Spain. 3. Fundació per la Docència i Recerca MútuaTerrassa, Terrassa, Catalonia, Spain. 4. Infectious Diseases Department, Parc Sanitari Sant Joan de Déu - Hospital Sant Boi, Sant Boi Ll, Catalonia, Spain. 5. United States Army Medical Research and Material Command, Fort Detrick, MD, USA. 6. Neurology Department, Yale University, New Haven, CT, United States. 7. Spanish HIV/AIDS Research Network of Excellence (RIS), Madrid, Spain. 8. AIDS Neurological Center Department of Neurology, University of North Carolina, Chapel Hill, NC, USA. 9. Department of Engineering, Stanford University, Stanford, CA, USA. 10. Ifakara branch, Ifakara Health Institute, Ifakara, Tanzania. 11. Swiss Tropical and Public Health Institute, Basel, Switzerland. 12. University of Basel, Basel, Switzerland. 13. St Francis Referral Hospital, Ifakara, Tanzania. 14. Department of Infectious Diseases, University Hospital Basel, Basel, Switzerland. 15. Division of Infectious Diseases and Hospital Epidemiology, University of Basel, Basel, Switzerland. 16. ISGlobal, Hospital Clínic-Universitat de Barcelona, Barcelona, Catalonia, Spain. 17. Department of Infectious Diseases, Hospital del Mar, Hospital del Mar Research Institute (IMIM), Barcelona, Catalonia, Spain.
Abstract
OBJECTIVES: Few studies have assessed cognitive impairment among healthy people living with HIV (PLWH) who are stable on antiretroviral treatment (ART) in sub-Saharan Africa. METHODS: 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. RESULTS: 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. CONCLUSION: 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.
OBJECTIVES: Few studies have assessed cognitive impairment among healthy people living with HIV (PLWH) who are stable on antiretroviral treatment (ART) in sub-Saharan Africa. METHODS: 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. RESULTS: 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. CONCLUSION: 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.
Authors: C Bernard; H Font; Z Diallo; R Ahonon; J M Tine; F N Abouo; A Tanon; E Messou; M Seydi; F Dabis; J-F Dartigues; N de Rekeneire Journal: AIDS Behav Date: 2021-05-29