Prevalence and factors associated with probable HIV dementia in an African population: A cross-sectional study of an HIV/AIDS clinic population

Abstract

BackgroundThe HIV/AIDS infection is common in sub-Saharan Africa and is associated with psychological and neuro- cognitive impairment. These conditions, however, remain largely unrecognized. In this study we aimed to determine the prevalence of probable HIV dementia (PHD) in an HIV clinic population in Uganda and to delineate the factors associated with such impairment in these HIV positive individuals.MethodsSix hundred eighty HIV clinic attendees were surveyed in a cross sectional study. PHD was assessed using the International Dementia Scale (IHDS). Standardized measures were also used to assess clinical, psychological, social and demographic variables. Respondents were aged 18 years and above and did not have severe physical or mental health conditions. Multivariate analysis was conducted to identify associations between PHD and various factors.ResultsThe prevalence of probable HIV dementia was 64.4%. PHD was significantly associated with increasing stress scores and psychosocial impairment but not with age, BMI, CD4 count, use of HAART, or a diagnosis of depression or alcohol dependence.ConclusionThe prevalence of probable HIV dementia in an ambulatory adult HIV positive population in Uganda was 64.4%. Increasing stress scores and psychosocial impairment were significant contributing factors. Clinicians need to be aware of this and to make efforts to identify neuro-cognitive impairment. Secondly there is need for more studies to better understand the relationship between PHD and stress in HIV populations so as to inform patient care.

Prevalence of neurocognitive disorders and depression in a Brazilian HIV population

“…When we used the strategy described by Rodrigues et al (9) of shifting the cutoff point of the IHDS to ≤11 to increase the sensitivity up to 75.7% for the detection of less severe neurocognitive impairment, we identifi ed a prevalence of 71.2% (n=79) in our patients; these fi ndings are more consistent with the previously reported literature (11) (30) .…”

“…The researchers reported a 69% prevalence of neurocognitive disorders. A similar prevalence (64.4%) was reported by Nakku et al (30) , who evaluated the frequency of neurocognitive impairment in 680 HIV patients in Uganda using the IHDS as the instrument of measure.…”

Mental, Neurological, and Substance Use Disorders in People Living With HIV/AIDS in Low- and Middle-Income Countries

“…49,94 Unlike HIV-associated dementia, milder cognitive disorders are not associated with higher HIV viral load and lower CD4 + T-lymphocyte count, but they are associated with previous cardiovascular disease. 49 The prevalence of HAND in LMICs varies, ranging from 6% to 64% in children and adults [99][100][101][102][103][104][105][106] (Table 1). 96 Postulated mechanisms for mild cognitive disorders include direct ART toxicity, chronic immune activation, or immune reconstitution syndrome.…”

Determinants of Neurocognitive Impairment in HIV in a Cohort of Patients on Antiretroviral Therapy Followed in Bangui (Central African Republic)

“…A paper presented by Cross et al also raised the link between age and the NCD [36]. For against Nakku et al in their work on NCD risk factors in the population of Uganda reported that advanced age and neurocognitive disorders association was not demonstrated [37]. This phenomenon could be explained by certain stressful situations that seniors would face and which we have escaped.…”