Neurobehavioral effects of human immunodeficiency virus infection among former plasma donors in rural China

Abstract

The HIV epidemic in China has expanded rapidly in recent years, but little is known about the prevalence and features of HIV Associated Neurocognitive Disorders (HANDs) in this part of the world. We administered a comprehensive Western neuropsychological (NP) test battery to 203 HIV+ and 198 HIV-former plasma donors in the rural area of Anhui province. We found that 26% in the HIV-sample, and 46% in the HIV+ sample were infected with HCV, which can also have CNS effects. To classify NP impairment, we developed demographically corrected test norms based upon individuals free of both infections (N=141). Using a global summary score, NP impairment was found in 34.2% of the HIV mono-infected group and 39.7% of the co-infected group, as compared to 12.7% of the uninfected controls (p<.001). HIV+ participants with AIDS were more likely to be impaired (43%) than non-AIDS individuals (29%, p<.05). Lastly, when all infection groups were combined, participants with NP impairment reported more cognitive complaints (p<.01) and increased dependence in everyday functioning (p=.01). In sum, NP impairment in this large rural Chinese sample was associated with both HIV and HCV infections, and the impairment's prevalence, severity, and pattern were similar to those reported by Western studies. Clinical significance of NP impairment in this population is suggested by the participants' reports of reduced everyday functioning. These findings indicate that HAND is likely to be an important feature of HIV infection in developing countries, underscoring the need for international efforts to develop CNS relevant treatments.

Neuropsychological Functioning and Antiretroviral Treatment in HIV/AIDS: A Review

“…Despite this success, HAND has not been eradicated and remains as prevalent as before CART (i.e., up to 50% in advanced HIV-positive individuals). Several prevalence studies have provided cumulative evidence of these pictures in different parts of the world (Sacktor et al 2002;Cysique et al 2004b;Robertson et al 2007a;Tozzi et al 2007;Heaton et al 2008;Wright et al 2008). To some extent this high prevalence might be attributed to HAND cases who initially improved on HAART, and then relapsed despite long-term treatment (up to 69% of cases; Tozzi et al 2007).…”

Characterization of HIV-Associated Neurocognitive Disorders Among Individuals Starting Antiretroviral Therapy in South Africa

“…Such disorders impact negatively on social and occupational functioning. In addition, they may be associated with increased risk behaviors and decreased adherence to medication [1][2][3]. Although the prevalence of HAND is well-established in some regions, there is less data on prevalence and risk factors in areas where clade C HIV predominates, such as South Africa.…”

Associations between neurocognitive functioning and social and occupational resilience among South African women exposed to childhood trauma

“…We administered a standard neurocognitive battery assessing seven domains (learning, delayed recall, processing speed, attention/working memory, executive function, verbal fluency, and motor ability) typically administered in HIV research (Heaton et al, 2010). Neurocognitive tests were adapted to the local South African context (Spies, Fennema-Notestine, Cherner, & Seedat, 2017), with specific cultural modifications for the South African context made to the Hopkins Verbal Learning Test-Revised (HVLT-R) (replacing precious stones with vegetables) and the Controlled Oral Word Association Task (COWAT) (changing the letter stimulus).…”