Vitamin D is not associated with HIV-associated neurocognitive disorder in Rakai, Uganda

Saylor, Deanna; Nakigozi, Gertrude; Pardo, Carlos A.; Kisakye, Alice; Kumar, Anupama; Nakasujja, Noeline; Robertson, Kevin; Gray, Ronald H.; Wawer, Maria J.; Sacktor, Ned

doi:10.1007/s13365-018-00719-6

Cited by 5 publications

(7 citation statements)

References 20 publications

(23 reference statements)

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“…The reported HAND prevalence ranges from 21% (7) to 86% (8). Factors that are associated with the prevalence of HAND range from demographic (e.g., age, sex distribution, education, and country) to clinical (e.g., current/nadir CD4 T cell-count, HCV coinfection, and types of ART) and psychosocial variables [e.g., depression, anxiety, and stigma; (7,(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)]. However, the results are still mixed across studies.…”

Section: Introductionmentioning

confidence: 99%

The Prevalence of Frascati-Criteria-Based HIV-Associated Neurocognitive Disorder (HAND) in HIV-Infected Adults: A Systematic Review and Meta-Analysis

Wei

Hou

et al. 2020

Front. Neurol.

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Background: The HIV associated mortality is decreasing in most countries due to the widespread use of antiretroviral therapy. However, HIV-associated neurocognitive disorder (HAND) remains a problematic issue that lowers the quality of life and increases the public health burden among people living with HIV. The prevalence of HAND varies across studies and selected samples. Therefore, we aimed to quantitatively summarize the pooled prevalence of Frascati-criteria-based HAND and to explore the potential demographic, clinical, and immunological factors.Methods: A comprehensive literature search in PubMed/Medline, Web of Science, Embase, and PsycINFO was performed. A random-effects meta-analysis was conducted using the event rate (ER) for the estimation of the incidence of HAND. Subgroup meta-analyses were used to evaluate between-group differences in categorical variables. Meta-regression with the unrestricted maximum likelihood (ML) method was used to evaluate associations of continuous variables.Results: Eighteen studies whose sample sizes ranged from 206 to 1555 were included in the final analyses. The estimated prevalence of HAND, ANI, MND and HAD were 44.9% (95% CI 37.4–52.7%), 26.2% (95% CI 20.7–32.7%), 8.5% (95% CI 5.6–12.7%), 2.1% (95% CI 1.2–3.7%), respectively. Factors associated with HAND were percent female, current CD4 count, education level and country development level (all ps < 0.05).Conclusion: Longitudinal cohort and multimodal neuroimaging studies are needed to verify the clinical prognosis and the underlying neurocognitive mechanism of HAND. In addition, it is urgently necessary to establish a standardized HAND diagnostic process.

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Section: Introductionmentioning

confidence: 99%

The Prevalence of Frascati-Criteria-Based HIV-Associated Neurocognitive Disorder (HAND) in HIV-Infected Adults: A Systematic Review and Meta-Analysis

Wei

Hou

et al. 2020

Front. Neurol.

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“…19 In Uganda, studies investigating severe neurocognitive impairment were conducted mainly among people below 60 years living with HIV. [20][21][22][23][24] The neurocognitive disorder explored commonly was HIV-acquired neurocognitive disorder, whose prevalence ranged from 41 to 58%. [20][21][22][23][24] However, a recent community-based study involving the general population; in Uganda aged 60 years about neurocognitive disorders, particularly Alzheimer's disease, found the prevalence to be at 20%, but its relationship with functional decline was not explored.…”

Section: Introductionmentioning

confidence: 99%

“…[20][21][22][23][24] The neurocognitive disorder explored commonly was HIV-acquired neurocognitive disorder, whose prevalence ranged from 41 to 58%. [20][21][22][23][24] However, a recent community-based study involving the general population; in Uganda aged 60 years about neurocognitive disorders, particularly Alzheimer's disease, found the prevalence to be at 20%, but its relationship with functional decline was not explored. 25 Therefore, the present study aimed to investigate the prevalence and sociodemographic factors and functional dependence associated with severe neurocognitive impairment within the older persons attending a tertiary hospital in southwestern Uganda.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of Severe Neurocognitive Impairment and Its Association with Socio-Demographics and Functionality Among Ugandan Older Persons: A Hospital-Based Study

Atim

Kaggwa

Mamun³

et al. 2021

CIA

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Background:The prevalence of neurocognitive disorders, especially dementia, is rising due to an increase in longevity. Early detection and diagnosis of neurocognitive impairments are important for early interventions and appropriate management of reversible causes, especially by the primary health workers. However, this study aimed to determine the prevalence and associated factors of severe neurocognitive impairment among elderly persons attending a tertiary hospital in Uganda. Methods: This cross-sectional survey was conducted in a Ugandan hospital setting, where older adults go for treatment for their chronic health problems. Following the inclusion criteria, interviews were conducted, where information about socio-demographics was collected, whereas neurocognitive impairment and functionality were assessed by Mini-Mental State Examination and Barthel Index, respectively. Chi-square test, Pearson correlation test, and logistic regression were performed to determine the factors associated with severe neurocognitive impairment. Results: A total of 507 elderly persons aged 60 years and above were enrolled in this study (mean age 68.62 ±7.95 years), and the prevalence of severe neurocognitive impairment was 28.01%. Advanced age, female gender, lower education level, and functional dependency were significantly associated with severe neurocognitive impairment. Conclusion:Severe neurocognitive impairment is prevalent among Ugandan hospital attending elderlies with functional dependency. This suggests a need to routinely screen cognitive disorders among older persons who visit the healthcare facilities with other physical complaints to enable early detection and treatment of reversible causes of neurocognitive impairment, such as depression and delirium to enable better functionality.

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“…Impairment on any outcome at the initial visit and follow-up time points was defined as ≥ 1 SD. HAND stage was determined using the Frascati criteria (Antinori et al 2007) consistent with our previous publications in Uganda (Abassi et al 2017;Sacktor et al 2009Sacktor et al , 2013Saylor et al 2019). In brief, ANI was defined as ≥1 SD on at least 2 different NP tests and absence of functional complaints; MND was defined as ≥ 1 SD on at least 2 different NP tests and functional complaints; HAD was defined as ≥ 2 SD on at least 2 different NP tests and functional complaints.…”

Section: Np Outcomesmentioning

confidence: 96%

Heterogeneity in neurocognitive change trajectories among people with HIV starting antiretroviral therapy in Rakai, Uganda

et al. 2019

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Considerable heterogeneity exists in patterns of neurocognitive change in people with HIV (PWH). We examined heterogeneity in neurocognitive change trajectories from HIV diagnosis to 1-2 years post-antiretroviral therapy (ART). In an observational cohort study in Rakai, Uganda, 312 PWH completed a neuropsychological (NP) test battery at two-time points (ART-naïve, 1-2 years post-ART initiation). All NP outcomes were used in a latent profile analysis to identify subgroups of PWH with similar ART-related neurocognitive change profiles. In a subset, we examined subgroup differences pre-ART on cytokine and neurodegenerative biomarkers CSF levels. We identified four ART-related change subgroups: (1) decline-only (learning, memory, fluency, processing speed, and attention measures), (2) mixed (improvements in learning and memory but declines in attention and executive function measures), (3) no-change, or (4) improvement-only (learning, memory, and attention measures). ART-related NP outcomes that are most likely to change included learning, memory, and attention. Motor function measures were unchanged. Subgroups differed on eight of 34 pre-ART biomarker levels including interleukin (IL)-1β, IL-6, IL-13, interferon-γ, macrophage inflammatory protein-1β, matrix metalloproteinase (MMP)-3, MMP-10, and platelet-derived growth factor-AA. The improvement-only and mixed

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Vitamin D is not associated with HIV-associated neurocognitive disorder in Rakai, Uganda

Cited by 5 publications

References 20 publications

The Prevalence of Frascati-Criteria-Based HIV-Associated Neurocognitive Disorder (HAND) in HIV-Infected Adults: A Systematic Review and Meta-Analysis

The Prevalence of Frascati-Criteria-Based HIV-Associated Neurocognitive Disorder (HAND) in HIV-Infected Adults: A Systematic Review and Meta-Analysis

Prevalence of Severe Neurocognitive Impairment and Its Association with Socio-Demographics and Functionality Among Ugandan Older Persons: A Hospital-Based Study

Heterogeneity in neurocognitive change trajectories among people with HIV starting antiretroviral therapy in Rakai, Uganda

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