Prevalence and Correlates of HIV-Associated Neurocognitive Disorders (HAND) in Northwestern Nigeria

Abstract

HIV-associated Neurocognitive Disorders (HAND) are common among HIV-positive individuals. This study explored the prevalence and correlates of HAND in Nigeria. 80 HIV-positive and 40 HIV-negative adults selected from Aminu Kano Teaching Hospital (AKTH) received comprehensive evaluations. A multidomain neuropsychological test (MDNPT) battery assessing 7 domains was administered to the participants and their performance was combined with measures of functional status to classify impairments into various grades of HAND. Univariate and multivariate analyses were performed to identify correlates of symptomatic HAND. Among the HIV-positive individuals, 50% were highly active antiretroviral therapy-experienced (HAART+) and 50% were highly active antiretroviral therapy naive (HAART−). Symptomatic HAND was found among 40% of the HAART− individuals and 30% of the HAART+ individuals. Respective prevalence of HIV-associated dementia (HAD) was 23% and 5%, respectively (p = 0.0002). In a binary logistic regression model, only fewer years of education independently predicted symptomatic HAND [Odds Ratio (OR) = 1.2, 95% confidence interval (CI) = 1.04–1.44, p = 0.016]. The prevalence of HAND in Nigeria is high with HAD being commoner among HAART− patients. Provision of HAART and strict monitoring of patients at risk of HAND are needed to scale down the burden of the disease.

High prevalence of neurocognitive disorders observed among adult people living with HIV/AIDS in Southern Ethiopia: a cross-sectional study

“…However, the prevalence of HAND in the current study was higher than a cross-sectional study done in Brazil (53%)(16), (53%)(4), in Botswana (38%)(8) Indonesia (51%)(26), Nigeria 30%(20), South Africa (25%) (27), South Asia (22.7%) (13) and in Ethiopia at Debre Markos North West (24.8%) (17), Dessie (36.4%) (18) and the Mekele referral hospital Northern Ethiopia 33.3% (21). The differences might be accounted to the neurovirulence strain differences and sociodemographic differences.…”

<p>Prevalence and Predictors of Neurocognitive Impairment in Ethiopian Population Living with HIV</p>

“…Gender, education, marital status, current CD4 count and hospital stay were included in the model based on previous studies showing them to be consistent predictors for neurocognitive impairment. [25][26][27][28][29][30][31][32] The logistic regression model was statistically significant, χ2 (9) = 72.91. The model explained 35.0% (Nagelkerke R 2 ) of the variance in neurocognitive impairment status and correctly classified 75.8% of cases.…”

Determining the Neurocognitive Status and the Functional Ability of Patients to Screen for HIV-Associated Neurocognitive Disorder (HAND)

“…Since our study was a cross sectional in design, possibly a onetime assessment of CD4 counts and its association with HAND was inconclusive. A study in Nigeria by Yakasai et al 21 also reported a similar result in which HAND was found in 40% of the pre-ART group and 30% of the ART group. This finding signified that HAND is common in the present ART era and also implied that ART does not apparently prevent the development nor successfully treat HAND among PLHIV.…”

“…https://dnd.or.kr In the Charter study the prevalence of HAND was 52% as assessed by detailed neurocognitive test battery. 11 Yakasai et al 21 also explored the prevalence of HAND in Nigeria by using a MDNPT battery combined with measures of functional status by using PAOFI and Karnofsky performance scale and reported HAND prevalence of 40% in ART naive and 30% in on ART subjects.…”