Association between education level and HIV-associated neurocognitive disorder: a systematic review and meta-analysis

Sexual Health ◽  
2020 ◽  
Vol 17 (6) ◽  
pp. 475
Author(s):  
Bozhi Liu ◽  
Wei Li
Keyword(s):  
Meta Analysis ◽  
Neurocognitive Impairment ◽  
Education Level ◽  
Neurocognitive Disorder ◽  
Hiv Dementia ◽  
Education Attainment ◽  
Hiv Patients ◽  
Low Education ◽  
Hiv Associated Neurocognitive Disorder ◽  
The Relationship

In the era of antiretroviral treatment, human immunodeficiency virus (HIV)-associated neurocognitive disorder (HAND) is common in HIV-positive (HIV+) patients, with an incidence of 30–50%. The relationship between education level and HAND has been evaluated in some studies, however, the results were inconsistent. The aim of this meta-analysis was to provide compelling evidence on the association between education level and the risk of HAND. Reports were searched for in the databases of Medline, Embase and PsyclNFO. Studies evaluating the relationship between education level and HAND in adult HIV+ patients were included. The pooled odds ratio/risk ratio was analysed by using the random-effects model. Two subgroup analyses were performed according to the adjustment of educational level in the neurocognitive impairment assessment and the income level. In total, 18 studies were included. Six studies and 12 studies reported education level as the continuous variable and categorical variable, respectively. The methods used for the assessment of neurocognitive impairment in included studies were neuropsychological battery tests (n = 10), HIV Dementia Scale (n = 1), the International HIV Dementia Scale (n = 6) and the Chinese version of the Montreal Cognitive Assessment (n = 1). The result showed that the risk of HAND in HIV+ patients who have lower education attainment was significantly higher than that in HIV+ patients who have higher education attainment. In conclusion, this meta-analysis demonstrated that HIV+ patients who have low education attainment carry higher risk of developing HAND compared with HIV+ patients who have high education attainment. This study highlighted the importance of early neurological screening for HIV+ patients who have low education level.

scholarly journals 7,8-dihydroxyflavone Improves Neuropathological Changes in the Brain of Tg26 Mice, A Model for HIV-associated Neurocognitive Disorder

2020 ◽  
Author(s):  
Joseph Bryant ◽  
Sanketh Andhavarapu ◽  
Christopher Bever ◽  
Poornachander Guda ◽  
Akhil Katuri ◽  
...  
Keyword(s):  
Therapeutic Potential ◽  
Brain Regions ◽  
Mitochondrial Damage ◽  
Data Sets ◽  
Neurocognitive Disorder ◽  
Hiv Patients ◽  
Neuroprotective Effects ◽  
Downstream Signaling ◽  
Hiv Associated Neurocognitive Disorder ◽  
The Brain

Abstract Background: The combined antiretroviral therapy (cART) era has significantly increased the lifespan of HIV patients, turning a fatal disease to a chronic one. However, this lower but persistent level of HIV infection increases the susceptibility of HIV-associated neurocognitive disorder (HAND). Therefore, research is currently seeking improved treatment for this complication of HIV. In HIV+ patients, low levels of brain derived neurotrophic factor (BDNF) has been associated with worse neurocognitive impairment. Hence, BDNF administration has been gaining relevance as a possible adjunct therapy for HAND. However, systemic administration of BDNF is impractical because of poor pharmacological profile.Methods: We investigated the neuroprotective effects of BDNF-mimicking 7,8 dihydroxyflavone (DHF), a bioactive high-affinity TrkB agonist, in the memory-involved hippocampus and brain cortex of Tg26 mice, a murine model for HAND. We immunohistochemically stained brain tissue sections from vehicle-treated wild type (WT), vehicle-treated Tg26, and DHF (5 mg/kg, i.p)-treated Tg26 mice to examine activation of TrkB and downstream signaling, expression of HIV-1 chemokine co-receptors CXCR4 and CCR5, neuroinflammation, and mitochondrial damage. A one-way ANOVA with a Bonferroni Comparison post-hoc test was performed to analyze the data sets. Results: In the brain regions of Tg26 mice, we observed astrogliosis, increased CXCR4 and CCR5 expression, neuroinflammation, and mitochondrial damage. Hippocampi and cortices of DHF treated mice exhibited a reversal of these pathological changes, suggesting the therapeutic potential of DHF in HAND. Our data indicates that DHF increases the phosphorylation of TrkB, providing new insights about the role of the TrkB-Akt-NFkB signaling pathway in mediating these pathological hallmarks.Conclusions: Our study provides an overview of how targeting BDNF-TrkB signaling in the pathophysiology of HAND may be relevant for future therapies, and sheds light on 7,8 Dihydroxyflavone as a potential adjunct therapeutic agent to current antiviral therapy.

scholarly journals Prevalence of HIV-associated neurocognitive disorder (HAND) and its subgroups among HIV-positive persons on anti-retroviral therapy in Iran

Psihologija ◽  
2020 ◽  
Vol 53 (2) ◽  
pp. 115-127
Author(s):  
Elham Mazaheri-Tehrani ◽  
Vahid Nejati ◽  
Alinaghi Seyed ◽  
Omid Dadras ◽  
Andrea Cossarizza ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Disease Duration ◽  
Hiv Positive ◽  
Neurocognitive Disorder ◽  
Educational Levels ◽  
Cd4 Counts ◽  
The Mean ◽  
Hiv Associated Neurocognitive Disorder ◽  
New Biomarkers ◽  
The Relationship

This study aimed to determine the prevalence and determinants of HIV-associated neurocognitive disorder (HAND) and its subgroups in HIV-positive patients in Tehran, Iran. Ninety-three HIV-positive individuals were assessed; the majority were male (60%) and the mean age of patients was 36.5 years (SD = 9), with 8 years as the median duration of HIV infection. The relationship between demographic and clinical variables was examined using logistic regression analysis. The overall prevalences of HAND and cognitive complaints were 50.5% and 73%, respectively. Lower nadir CD4 counts (? 200), lower educational levels (? 12 years), longer disease duration (? 5years), and higher depression rates were positively associated with the presence of HAND. This study shows that the prevalence of HANDs in Iran is high, but similar to the prevalence levels found in Western societies. Further studies are needed to longitudinally evaluate the presence of HAND, in particularly to recognize new biomarkers and specific neurocognitive domains in HIV.

Meta Analysis: The Relationship Of Knowledge And Education Level Of The Mother With Dental Caries In Children

2021 ◽  
Vol 11 (7) ◽  
pp. 16-23
Author(s):  
Akbar Nazarullah Syada ◽  
Syamsul Arifin ◽  
Izaak Zoelkarnain ◽  
Ari Yunanto ◽  
Lenie Marlinae
Keyword(s):  
Dental Caries ◽  
Meta Analysis ◽  
Education Level ◽  
Relationship Of ◽  
The Relationship

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

2020 ◽  
Vol 11 ◽  
Author(s):  
Jiaqi Wei ◽  
Jianhua Hou ◽  
Bin Su ◽  
Taiyi Jiang ◽  
Caiping Guo ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Categorical Variables ◽  
Diagnostic Process ◽  
People Living With Hiv ◽  
Neurocognitive Disorder ◽  
Continuous Variables ◽  
Clinical Prognosis ◽  
Public Health Burden ◽  
Hiv Associated Neurocognitive Disorder ◽  
Meta Analyses

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.

scholarly journals Lower brain glutamate is associated with cognitive deficits in HIV patients: A new mechanism for HIV-associated neurocognitive disorder

2010 ◽  
Vol 32 (5) ◽  
pp. 1045-1053 ◽  
Author(s):  
Thomas Ernst ◽  
Caroline S. Jiang ◽  
Helenna Nakama ◽  
Steven Buchthal ◽  
Linda Chang
Keyword(s):  
Cognitive Deficits ◽  
Neurocognitive Disorder ◽  
Hiv Patients ◽  
Hiv Associated Neurocognitive Disorder

scholarly journals Utility of the International HIV Dementia Scale for HIV-Associated Neurocognitive Disorder

2020 ◽  
Vol 83 (3) ◽  
pp. 278-283
Author(s):  
Maria Molinaro ◽  
Ned Sacktor ◽  
Gertrude Nakigozi ◽  
Aggrey Anok ◽  
James Batte ◽  
...  
Keyword(s):  
Neurocognitive Disorder ◽  
Hiv Dementia ◽  
Hiv Associated Neurocognitive Disorder ◽  
International Hiv Dementia Scale

Population-based study in Lithuania: lifestyle factors and risk of metabolic syndrome

Open Medicine ◽  
2010 ◽  
Vol 5 (3) ◽  
pp. 387-398
Author(s):  
Dalia Luksiene ◽  
Migle Baceviciene ◽  
Abdonas Tamosiunas
Keyword(s):  
Metabolic Syndrome ◽  
Alcohol Intake ◽  
International Diabetes Federation ◽  
Population Based ◽  
Education Level ◽  
Population Based Study ◽  
Aged Population ◽  
Low Education ◽  
The Relationship ◽  
Nutrition Habits

AbstractThe aim of this study was to assess the relationship between lifestyle characteristics and the probability of metabolic syndrome in the Lithuanian middle-aged population of Kaunas city. Study sample was comprised of 1403 individuals aged 35–64 years. Metabolic syndrome was defined by International Diabetes Federation definition. Lifestyle habits were evaluated using frequency questionnaires. The prevalence of metabolic syndrome was identified in 29.7% of men and 35.1% of women. In men only alcohol intake increased the risk of metabolic syndrome: wine intake daily or several times a week increased the risk of metabolic syndrome in men aged 35–49 years by 3.8-fold whereas intake of spirits once a week or more often increased the risk of metabolic syndrome in men aged 50–64 years by 2.8-fold. In women aged 50–64 years beer intake daily or several times a week (OR=11.9; p=0.015) and some unhealthy nutrition habits — intake of cakes 4 times a week or more often (OR=5.49; p=0.005) and slather spread butter on bread (OR=2.09; p=0.028) increased the odds of metabolic syndrome. Our findings indicated that frequent intake of wine and spirits increased the risk of metabolic syndrome in men; frequent intake of beer, cakes, slather spread butter on bread and low education level increased the risk of metabolic syndrome in women.

scholarly journals Education Level and Long‐term Mortality, Recurrent Stroke, and Cardiovascular Events in Patients With Ischemic Stroke

2020 ◽  
Vol 9 (16) ◽  
Author(s):  
Bizhong Che ◽  
Suwen Shen ◽  
Zhengbao Zhu ◽  
Aili Wang ◽  
Tan Xu ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Cardiovascular Events ◽  
Recurrent Stroke ◽  
Meta Analysis ◽  
Education Level ◽  
Chinese Patients ◽  
Increased Risk ◽  
All Cause Mortality ◽  
Specific Mortality ◽  
The Relationship

Background Epidemiological studies have reported discrepant findings on the relationship between education level and outcomes after stroke. We aimed to prospectively investigate the relationship between education level and mortality, recurrent stroke, and cardiovascular events in Chinese patients with ischemic stroke. Methods and Results We included 3861 participants from the China Antihypertensive Trial in Acute Ischemic Stroke. Education level was categorized as illiteracy, primary school, middle school, and college. Study outcomes were all‐cause mortality, stroke‐specific mortality, recurrent stroke, and cardiovascular events within 2 years after ischemic stroke. A meta‐analysis was conducted to incorporate the results of the current study and previous other studies on the association of education level with outcomes after stroke. Within 2 years after ischemic stroke, there were 327 (8.5%) all‐cause deaths, 264 (6.8%) stroke‐specific deaths, 303 (7.9%) recurrent strokes, and 364 (9.4%) cardiovascular events, respectively. The Kaplan–Meier curves showed that patients with the lowest education level had the highest cumulative incidence rates of all‐cause mortality, stroke‐specific mortality, and cardiovascular events (log‐rank P ≤0.01). After adjusted for covariates, hazard ratios and 95% CIs of illiteracy versus college education were 2.79 (1.32–5.87) for all‐cause mortality, 3.68 (1.51–8.98) for stroke‐specific mortality, 2.82 (1.20–6.60) for recurrent stroke, and 3.46 (1.50–7.95) for cardiovascular events. The meta‐analysis confirmed the significant association between education status and mortality after stroke (pooled relative risk for lowest versus highest education level, 1.24 [95% CI, 1.05–1.46]). Conclusions Low education level was significantly associated with increased risk of mortality, recurrent stroke, and cardiovascular events after ischemic stroke, independently of established risk factors. Registration URL: https://www.clini​caltr​ials.gov ; Unique identifier: NCT01840072.

scholarly journals The importance of well-being and education for the initiation and duration of breastfeeding in Ireland; Findings from the ROLO study

2020 ◽  
Vol 79 (OCE2) ◽  
Author(s):  
Cara Yelverton ◽  
Aisling Geraghty ◽  
Eileen O'Brien ◽  
Sarah Louise Killeen ◽  
Fionnuala McAulliffe
Keyword(s):  
Intervention Group ◽  
Well Being ◽  
Education Level ◽  
Breastfeeding Duration ◽  
Randomised Control Trial ◽  
Breastfeeding Initiation ◽  
Low Education ◽  
Education Levels ◽  
Duration Of Breastfeeding ◽  
The Relationship

AbstractIntroduction:Breastfeeding is well-established as optimal for both mother and baby, with a number of benefits including a quicker return to pre-pregnancy weight for the mother and the reduced risk of non-communicable diseases, including obesity, for the infant. The current global recommendation is to breastfeed exclusively for 6 months postpartum, yet in Ireland initiation and duration of breastfeeding is extremely low. Low education level is considered a barrier to breastfeeding, however, there is currently a paucity of research on the influence of maternal well-being on breastfeeding habits in Ireland.Aim:To explore the relationship between education levels and well-being in early pregnancy on breastfeeding habits in Irish women.Methods:This was a secondary analysis of the randomised control trial, the ROLO study in the National Maternity Hospital, Dublin, Ireland. 610 healthy, pregnant women on their 2nd pregnancy were included. Well-being was measured using the WHO-5 item well-being index at the end of the 1st trimester. Education level and breastfeeding initiation information were both obtained from hospital records. Women were stratified into two groups of education level; those that had achieved 3rd level education (n = 341), and those with less than 3rd level (n = 269). Within these two groups, the relationship between well-being scores and breastfeeding habits was explored using Pearson correlations, chi-square tests, and multiple regression modelling for confounders.Results:In Women with high education, those with high well-being (n = 269) were significantly more likely to initiate breastfeeding than those low well-being (n = 72; 69.5% vs 56.9%, p < 0.05). This association remained after controlling for maternal age, BMI, and intervention group (B = 0.57, p < 0.05). Well-being was not associated with breastfeeding duration in women with 3rd level education (26.63 weeks vs 25.64 weeks, p = 0.87). In women with low education levels, there was no association of well-being and breastfeeding initiation (37.4% vs 35.9%, p = 0.84) or well-being and breastfeeding duration (6.75 weeks vs 5.70 weeks, p = 0.65).Discussion:While education level is a strong indication of women's likelihood to breastfeed, it is important to recognise other influencing factors. Among highly educated women well-being was also important as a determinant of initiating breastfeeding. This is important for healthcare professionals working in maternity care in Ireland and highlights the potential of improving well-being and there-by increasing Irish breastfeeding rates.

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