scholarly journals Prevalence and predictors of HIV-associated Neurocognitive Disorder in Ethiopians

2020 ◽  
Author(s):  
Mohammed Salahuddin ◽  
Md Dilshad Manzar ◽  
Hamid Yimam Hassen ◽  
Mihretu Ashuro ◽  
Aleem Unissa ◽  
...  
Keyword(s):  
Risk Factors ◽  
Vulnerable Groups ◽  
Binary Logistic Regression Analysis ◽  
People Living With Hiv ◽  
Neurocognitive Disorder ◽  
Cross Sectional ◽  
Targeted Screening ◽  
Independent Risk Factors ◽  
Hiv Associated Neurocognitive Disorder ◽  
Living With Hiv

Abstract Background Modern antiretroviral therapy has extended the life expectancies of people living with HIV; the prevention and treatment of their associated neurocognitive decline has remained a challenge. Consequently, it is desirable to investigate the prevalence and predictors of HIV-associated Neurocognitive Disorder (HAND) to help in targeted screening and disease prevention. Methods: Two hundred and forty-four people living with HIV were interviewed in a study using a cross-sectional design and International HIV Dementia scale (IHDS). Additionally, the sociodemographic, clinical and psychosocial characteristics of the patients were recorded. Chi-square and binary logistic regression analysis were used to determine the level of significance among the independent risk factors and probable HAND. Results The point prevalence of HAND was found to be 39.3%. Participants’ characteristics of being older than 40 years (AOR = 2.81 (95% CI; 1.11–7.15)), having a history of recreational drug use (AOR = 13.67 (95% CI; 6.42–29.13)), and being non-compliant with prescribed medications (AOR = 2.99 (95% CI; 1.01–8.87)) were independent risk factors for HAND. Conclusion The identification of predictors, some of which may be more closely related to the Ethiopian people living with HIV, may help in targeted screening of vulnerable groups during cART follow-up visits. This may greatly help in strategizing and implementation of the prevention program, more so, because: (i) HAND is an asymptomatic condition for considerable durations, and (ii) clinical trials of HAND therapies have been unsuccessful.

scholarly journals A cross-sectional study of hepatitis C among people living with HIV in Cambodia: Prevalence, risk factors, and potential for targeted screening

PLoS ONE ◽  
2017 ◽  
Vol 12 (8) ◽  
pp. e0183530 ◽  
Author(s):  
Anja De Weggheleire ◽  
Sokkab An ◽  
Irith De Baetselier ◽  
Pisith Soeung ◽  
Huy Keath ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hepatitis C ◽  
Cross Sectional Study ◽  
People Living With Hiv ◽  
Sectional Study ◽  
Cross Sectional ◽  
Targeted Screening ◽  
Living With Hiv

scholarly journals High prevalence of neurocognitive disorders observed among adult people living with HIV/AIDS in Southern Ethiopia: a cross-sectional study

2018 ◽  
Author(s):  
Megbaru Debalkie Animut ◽  
Muluken Bekele Sorrie ◽  
Yinager Workneh ◽  
Manaye yihune Teshale
Keyword(s):  
Associated Factors ◽  
Cross Sectional Study ◽  
Neurocognitive Disorders ◽  
People Living With Hiv ◽  
Neurocognitive Disorder ◽  
Sectional Study ◽  
Cross Sectional ◽  
Hiv Associated Neurocognitive Disorder ◽  
Living With Hiv ◽  
Hiv Aids

AbstractBackgroundComprehensive care given to people living with HIV/AIDS is improving from time to time; however, their concurrent cognitive illness is still ignored, under screened and treated particularly in developing countries. And this problem is also striking in Ethiopia. Therefore, the objective of this study was to assess HIV-associated neurocognitive disorders and associated factors among adult people living with HIV/AIDS.MethodsAn institution based cross sectional study was conducted in Gamo Gofa zone public Hospitals from April to May, 2017. The systematic random sampling technique was used to select a total of 697 people living with HIV/AIDS. Data was collected using structured interviewer administered questionnaire and International HIV Dementia Scale was used to screen HIV-associated neurocognitive deficits. Data was entered using Epidata version 3.1 and analyzed using SPSS version 20. Both bivariable and multivariable logistic regression analyses were performed to identify associated factors. A P value 0.05 with 95% confidence level was used to declare statistical significance.ResultA total of 684 study participants were included with a 98 % response rate. From the total participants, 56% were females while 44% were males. The mean (±SD) age of the participants was 38.8±8.8years.The prevalence of HIV-associated neurocognitive disorder was 67.1% (95%CI; 63.6, 70.5). The multivariable logistic analysis indicated that body mass index 16 kg/m2 (AOR 4.149 (1.512-11.387)), being married (AOR 0.9 (0.604-0.623), unemployment (AOR 5.930 (3.013-11.670) and being in WHO clinical stage T3 category (AOR 2.870 (1.098-7.500) were the key predictors of HIV-associated neurocognitive disorders among people living with HIV/AIDS.ConclusionIn this study the prevalence of HIV-associated neurocognitive disorder is higher than the earlier reports in Ethiopia and Africa. The associated factors also vary from that of earlier studies. This indicates the need for formulating preventive mental health programs and policies for people living with HIV/AIDS.

“I’m Just Forgetting and I Don’t Know Why”: Exploring How People Living With HIV-Associated Neurocognitive Disorder View, Manage, and Obtain Support for Their Cognitive Difficulties

2018 ◽  
Vol 28 (6) ◽  
pp. 859-872 ◽  
Author(s):  
Alexander R. Terpstra ◽  
Catherine Worthington ◽  
Francisco Ibáñez-Carrasco ◽  
Kelly K. O’Brien ◽  
Aiko Yamamoto ◽  
...  
Keyword(s):  
Health Care ◽  
Lived Experience ◽  
Health Care Professionals ◽  
Management Strategies ◽  
Well Being ◽  
People Living With Hiv ◽  
Neurocognitive Disorder ◽  
Cognitive Difficulties ◽  
Hiv Associated Neurocognitive Disorder ◽  
Living With Hiv

HIV-associated neurocognitive disorder (HAND) is common, but the lived experience of HAND is not well-understood. In this descriptive qualitative study, we explored how adults with HAND view, manage, and obtain support for cognitive difficulties. We interviewed 25 participants (20% female; median age = 51 years) who were diagnosed with HAND using neuropsychological assessment and a clinical interview. Semistructured interviews, co-developed with community members living with HIV, focused on how cognitive difficulties manifested and progressed, impacted well-being, and were discussed with others. We analyzed interview transcripts using a team-based, thematic approach. Participants described concentration, memory, and multitasking difficulties that fluctuated over time, as well as potential risk factors, management strategies, and psychosocial consequences. They reported they seldom discussed cognitive impairment with health care professionals, and that receiving a HAND diagnosis was validating, informative, yet somewhat disconcerting. Conversations between health care professionals and people living with HIV about HAND may provide opportunities for education, assessment, and support.

Global prevalence and burden of HIV-associated neurocognitive disorder

Neurology ◽  
2020 ◽  
Vol 95 (19) ◽  
pp. e2610-e2621 ◽  
Author(s):  
Yunhe Wang ◽  
Moxuan Liu ◽  
Qingdong Lu ◽  
Michael Farrell ◽  
Julia M. Lappin ◽  
...  
Keyword(s):  
Data Extraction ◽  
Sub Saharan Africa ◽  
People Living With Hiv ◽  
Neurocognitive Disorder ◽  
Cross Sectional ◽  
Asymptomatic Neurocognitive Impairment ◽  
Cd4 Cell Count ◽  
Hiv Associated Neurocognitive Disorder ◽  
Sub Saharan ◽  
High Level

ObjectiveTo characterize the prevalence and burden of HIV-associated neurocognitive disorder (HAND) and assess associated factors in the global population with HIV.MethodsWe searched PubMed and Embase for cross-sectional or cohort studies reporting the prevalence of HAND or its subtypes in HIV-infected adult populations from January 1, 1996, to May 15, 2020, without language restrictions. Two reviewers independently undertook the study selection, data extraction, and quality assessment. We estimated pooled prevalence of HAND by a random effects model and evaluated its overall burden worldwide.ResultsOf 5,588 records identified, we included 123 studies involving 35,513 participants from 32 countries. The overall prevalence of HAND was 42.6% (95% confidence interval [CI] 39.7–45.5) and did not differ with respect to diagnostic criteria used. The prevalence of asymptomatic neurocognitive impairment, mild neurocognitive disorder, and HIV-associated dementia were 23.5% (20.3–26.8), 13.3% (10.6–16.3), and 5.0% (3.5–6.8) according to the Frascati criteria, respectively. The prevalence of HAND was significantly associated with the level of CD4 nadir, with a prevalence of HAND higher in low CD4 nadir groups (mean/median CD4 nadir <200 45.2% [40.5–49.9]) vs the high CD4 nadir group (mean/median CD4 nadir ≥200 37.1% [32.7–41.7]). Worldwide, we estimated that there were roughly 16,145,400 (95% CI 15,046,300–17,244,500) cases of HAND in HIV-infected adults, with 72% in sub-Saharan Africa (11,571,200 cases, 95% CI 9,600,000–13,568,000).ConclusionsOur findings suggest that people living with HIV have a high burden of HAND in the antiretroviral therapy (ART) era, especially in sub-Saharan Africa and Latin America. Earlier initiation of ART and sustained adherence to maintain a high-level CD4 cell count and prevent severe immunosuppression is likely to reduce the prevalence and severity of HAND.

Alzheimer Disease and HIV: Untangling the Gordian Knot

2021 ◽  
pp. 10.1212/CPJ.0000000000001102
Author(s):  
Lambros Messinis ◽  
Grigorios Nasios
Keyword(s):  
Future Research ◽  
People Living With Hiv ◽  
Neurocognitive Disorder ◽  
Population Means ◽  
Aged People ◽  
Highly Active ◽  
Hiv Associated Neurocognitive Disorder ◽  
Living With Hiv ◽  
Long Term Survivors

Approximately one decade ago, Brew and Mystique, 1 in their compelling editorial addressed the need for conducting further studies of amyloid metabolism in aged people living with HIV. They also noted the need for future research to provide tools capable of identifying the causes of HIV – Associated Neurocognitive Disorder (HAND) within the context of successful highly active anti-retroviral therapy (HAART). Alisky in 2007, 2 had accurately predicted that successful treatment with HAART in the HIV population means more long term survivors and an aging HIV population vulnerable to develop Alzheimer’s disease (AD).

scholarly journals Risk Factors and Pathogenesis of HIV-Associated Neurocognitive Disorder: The Role of Host Genetics

2018 ◽  
Vol 19 (11) ◽  
pp. 3594 ◽  
Author(s):  
Ian Olivier ◽  
Ramón Cacabelos ◽  
Vinogran Naidoo
Keyword(s):  
Risk Factors ◽  
Immune Response ◽  
Human Genetics ◽  
Hiv Treatment ◽  
Specific Gene ◽  
People Living With Hiv ◽  
Neurocognitive Disorder ◽  
Host Genetics ◽  
Hiv Associated Neurocognitive Disorder

Neurocognitive impairments associated with human immunodeficiency virus (HIV) infection remain a considerable health issue for almost half the people living with HIV, despite progress in HIV treatment through combination antiretroviral therapy (cART). The pathogenesis and risk factors of HIV-associated neurocognitive disorder (HAND) are still incompletely understood. This is partly due to the complexity of HAND diagnostics, as phenotypes present with high variability and change over time. Our current understanding is that HIV enters the central nervous system (CNS) during infection, persisting and replicating in resident immune and supporting cells, with the subsequent host immune response and inflammation likely adding to the development of HAND. Differences in host (human) genetics determine, in part, the effectiveness of the immune response and other factors that increase the vulnerability to HAND. This review describes findings from studies investigating the role of human host genetics in the pathogenesis of HAND, including potential risk factors for developing HAND. The similarities and differences between HAND and Alzheimer’s disease are also discussed. While some specific variations in host genes regulating immune responses and neurotransmission have been associated with protection or risk of HAND development, the effects are generally small and findings poorly replicated. Nevertheless, a few specific gene variants appear to affect the risk for developing HAND and aid our understanding of HAND pathogenesis.

scholarly journals Creating Productive Tensions: Clinicians Working with Patients as Peer Researchers in a Community-Based Participatory Research Study of the Lived Experience of HIV-Associated Neurocognitive Disorder (HAND)

2018 ◽  
Vol 19 (3) ◽  
pp. 53-72
Author(s):  
Francisco Ibáñez-Carrasco ◽  
Alexander Roy Terpstra ◽  
Sean Rourke ◽  
Aiko Yamamoto ◽  
Soo Ying Chan Carusone ◽  
...  
Keyword(s):  
Knowledge Transfer ◽  
Lived Experience ◽  
People Living With Hiv ◽  
Neurocognitive Disorder ◽  
Community Based ◽  
Community Based Research ◽  
Knowledge Transfer And Exchange ◽  
Hiv Associated Neurocognitive Disorder ◽  
Peer Researchers ◽  
Living With Hiv

About 50% of people living with HIV will develop HIV-associated neurocognitive disorder (HAND) during their lifetime, and we know that cognitive issues are a concern for people living with HIV. However, limited information exists regarding how HAND is managed and coped with, or how cognitive issues are discussed with others, including health care professionals. Following a community-based research approach, we conducted 25 interviews in 2016 aimed to (1) build the capacity of people living with HIV, (2) facilitate participant recruitment and data collection, (3) increase the validity and reliability of our data analysis results, and (4) facilitate knowledge transfer and exchange regarding HAND. After thorough training, we engaged a number of peer researchers living with HAND in the analysis and knowledge transfer and exchange (KTE) phases of the study. This engagement prompted a number of tensions between the clinicians and the peers that we learned to navigate and make productive. We conclude that it is possible to engage patients and providers only if careful attention, time and human resources are provided to navigating the emerging tensions. The outcomes of our study suggest that engaging an interdisciplinary team across multiple sites with PRAs is a valuable method for comprehensively exploring the lived experience of a complex chronic condition such as HAND. 

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