Reaction time in patients with HIV/AIDS and correlation with CD4 count: a case–control study

Abstract

There are conflicting reports on the presence of neurocognitive dysfunction during the initial, medically asymptomatic stage of HIV infection. This study aimed to assess the psychomotor speed and attention ability of antiretroviral treatment-naïve Nigerian Africans with HIV/AIDS and the impact of CD4 levels on their cognitive performance. Two hundred and eighty-eight randomly selected age-, sex- and level of education-matched subjects participated, comprising 96 HIV-positive asymptomatic and 96 HIV-positive symptomatic patients and 96 HIV-negative controls. The simple reaction and binary choice reaction time tasks were used for cognitive assessment. The binary choice reaction time indicated that the HIV-positive patients had impaired attention ability and significant psychomotor slowing compared with the controls (P<0.05), but psychomotor slowing was obvious among the symptomatic HIV-positive patients only using the simple reaction time tasks. Significant psychomotor retardation was observed in HIV-positive patients with CD4 levels of 200-499 cells/mm(3) (P=0.02) and <200 cells/mm(3) (P<0.001), and impaired ability for sustained attention was present irrespective of the CD4 level (P<0.001). We conclude that psychomotor retardation and impaired attention are significantly worse in HIV-positive subjects compared with controls and are adversely affected by decreasing CD4 levels. The sensitivity of the neuropsychological tool used can affect the degree of impairment measured.

Effects of highly active antiretroviral therapy on cognitive functions in severely immune-compromised HIV-seropositive patients

“…The reaction time and memory tasks fall into this category. This observation has been reported earlier by Ogunrin et al [40].…”

“…It consists of reaction time tasks (simple and choice), recognition memory tests, visual scanning task, seashore rhythm test, abstraction task (similar to Wisconsin card sorting task) and Corsi block task. This instrument has been validated among Nigerian adults by Ogunrin et al [39] and in HIV patients [40]. It takes about 25 min to administer the simple auditory and visual reaction times for assessment of mental speed, finger tapping task for motor speed, recognition word and figure tasks for verbal and visual memory respectively and binary choice reaction time for sustained attention.…”

Impact of Chronic Medical and Neuropsychiatric Illnesses on Quality of Life and Life Expectancy among Patients at the University of Port Harcourt Teaching Hospital (UPTH)

“…However, illnesses that have predominantly onset in early adulthood like schizophrenia or common among young adult like HIV had a high percentage of single people [21,24,27]. In addition to being predominant among young people, HIV and schizophrenia are associated with a high level of stigma [1,77,105], although stigma in the former seems to have reduced significantly over the years. Persons affected with schizophrenia particular early-onset type tend to have difficulty forming or sustaining relationship or even get married, and even those who are already married may face a high risk of separation due to fear of transmission.…”

“…The chronicity of these medical illnesses, persistent and recurrent symptoms, impairment in functioning capacity, other adverse and enduring environmental psychosocial burdens, and even the thought of these can also in turn affect quality of life and subsequently lower life expectancy. Although HIV-and tuberculosisinfected and cancer-affected patients under antiretroviral (arbacire, nevirapine), antituberculosis drug (isoniazid and cycloserine), and anticancer medication (methotrexate) therapy infrequently suffer acute organic psychotic complications, the chronicity of the disease places them at greater risk for psychiatric comorbidity than the general population [63][64][65][66][67][68][69][70][71][72][73][74][75][76][77].…”

Effect of vinpocetine (cognitol™) on cognitive performances of a Nigerian population

“…These tools used in previous studies, which included Community Screening Instrument for Dementia,[14151617] Iron Psychology (acronym FePsy),[1218] modified HIV dementia scale[19] and mini-mental state examination,[20] have been validated. Despite this, cognitive assessment is not routinely done in most sub-Saharan neurological clinics including Nigeria.…”