Worldwide Occurrence of HIV-Associated Neurocognitive Disorders and Its Associated Factors: A Systematic Review and Meta-Analysis

Abstract

BackgroundHIV-associated neurocognitive disorders are common in people living with HIV/AIDS and affect the adherence of patients to prescriptions, activities of daily living, and quality of life of patients. However, there is a lack of summative evidence in the area. The present meta-analysis was therefore addressing this gap.MethodsWe did our electronic search in Psych-Info, EMBASE, Scopus, and PubMed. The retrieved articles were stored with the endnote reference manager and data was extracted using Meta-XL version 5.3. The quality of studies was evaluated with the modified Newcastle–Ottawa Scale (NOS). A random-effect model and STATA-16 were used to compute the average estimate of HAND. Heterogeneity was weighed with I2 statistics. A sensitivity analysis and subgroup analysis were employed. The existence/nonexistence of a publication bias was checked with the Eggers test of publication bias.ResultsThe average prevalence of HAND was 50.41% (95% CI: 45.56, 55.26). The average estimate of HAND in Europe was found to be 50.015% whereas in Africa, Asia, and the United States of America (USA) it was 49.566, 52.032, and 50.407% respectively. The prevalence of HAND in studies that used the HIV Dementia Scale (IHDS) was 36.883% and 59.956% at cutoff points of IHDS <9.5 and IHDS <10 respectively. Besides, the estimated average of HAND with the global dementia scale (GDS) was 40.766%. The prevalence of HAND in cross-sectional, cohort, and case-control studies was 49.52, 54.087, and 44.45% in that order. Socio-demographic variables; low level of education and older age, clinical and HIV related variables; the advanced stage of the illness and CD4 count of 500 cells/dl or less and psychological variables such as comorbidity of depression increases the risk of HAND.ConclusionThe prevalence of HIV-associated neurocognitive disorders was about 50.41%. Low level of education and older age, clinical and HIV related variables such as the advanced stage of the illness and CD4 count of 500 cells/dl or less, and comorbidity of depression were associated with HIV associated neurocognitive disorders. Public health interventions for HIV patients should target these essential problems.

Health-related quality of life and associated factors among people living with HIV/AIDS in Sichuan, China: A cross-sectional study

“…A further 10.5% were illiterate. Consistent with the findings of previous studies ( 42 , 46 , 47 ), educational level was a protective factor of HRQoL. Moreover, having no formal education is a barrier to accessing health services and increasing PLWH vulnerability ( 48 ).…”

“…It plays an important role in the spread and prevalence of HIV ( 49 ) and is more likely to lead to risky sexual behavior ( 50 ). Well-educated PLWH were more likely to show good knowledge, positive attitudes toward HIV/AIDS ( 48 ) and good social support ( 47 ) and cognitive level ( 42 , 46 ), which leads to better self-management and health outcomes. Although education level is difficult to change, we recommend that more health information and education be provided through brochures, bulletin boards, and public online platforms.…”

Neurocognitive Impairment and Associated Factors Among People Living with HIV: A Systematic Review and Meta-Analysis of African Studies

“… 44 The current pooled prevalence was lower than the global pooled prevalence of HIV-associated neurocognitive disorders 50.41% (Total number of study participants=14,107). 45 The discrepancy could be due to the study period, sample size, and the ART status of the study participants. It reaffirmed that ART confers substantial benefits against NCI, lowering it by over 60%.…”

Microglia Proliferation Underlies Synaptic Dysfunction in the Prefrontal Cortex: Implications for the Pathogenesis of HIV-1-Associated Neurocognitive and Affective Alterations

“…The central nervous system (CNS), however, is infiltrated with infected monocytes and CD4+ cells within days of HIV infection (Koenig et al, 1986; Whitney et al, 2014). Consequently, nearly half of HIV-1 seropositive individuals are afflicted with debilitating neurocognitive impairments (NCI; Wang et al, 2020; Zenebe et al, 2022) and/or affective (Campos et al, 2010; Kamat et al, 2013) alterations. Indeed, HIV-1-associated neurocognitive disorders (HAND) are characterized by deficits in attention, memory, and executive function (Heaton et al, 2011), whereas affective alterations include both apathy and depression (for review, Cysique & Brew, 2019).…”