HIV-associated neurocognitive impairment in stable people living with HIV on ART in rural Tanzania.
Por:
Montserrat Sanmartí Villamala, Meyer AC, Jaen A, Robertson K, Tan N, Mapesi H, Samson L, Ndaki R, Battegay M, Tanner M, Weisser M, Dalmau D, Letang E and KIULARCO Group
Publicada:
1 feb 2021
Ahead of Print:
15 nov 2020
Resumen:
OBJECTIVES: Few studies have assessed cognitive impairment among healthy people living with HIV (PLWH) who are stable on antiretroviral treatment (ART) in sub-Saharan Africa. METHODS: We conducted a cross-sectional study among a random sample of stable adult PLWH from rural Tanzania on ART for more than 1 year and without immunological failure or pre-existing neurological disease. We evaluated the prevalence and risk factors for neurocognitive impairment (NCI), assessed through neuropsychological tests, functional and depression questionnaires and defined as a mean Z-score = -1 in two or more cognitive domains. RESULTS: Among 243 participants [median age = 44.3 years (interquartile range: 36-52] and 71% female] we found a rate of NCI of 19.3% (95% confidence interval: 14.8-24.8%). Memory and psychomotor domains demonstrated the highest impairment. Independent predictors of NCI were age and self-reported alcohol use. Other classical risk factors were not associated with HIV-associated NCI. CONCLUSION: Despite effective ART roll-out, NCI remained a prevalent condition in this healthy rural Tanzanian population of PLWH on ART. Age and alcohol use were key risk factors.
Filiaciones:
Montserrat Sanmartí Villamala:
Infectious Diseases & HIV Service, Hospital Universitari MutuaTerrassa, Terrassa, Spain
University of Barcelona, Catalonia, Barcelona, Spain
Fundació per la Docència i Recerca MútuaTerrassa, Terrassa, Catalonia, Spain
Infectious Diseases Department, Parc Sanitari Sant Joan de Déu - Hospital Sant Boi, Sant Boi Ll, Catalonia, Spain
Meyer AC:
United States Army Medical Research and Material Command, Fort Detrick, MD, USA
Neurology Department, Yale University, New Haven, CT, United States
Jaen A:
Fundació per la Docència i Recerca MútuaTerrassa, Terrassa, Catalonia, Spain
Spanish HIV/AIDS Research Network of Excellence (RIS), Madrid, Spain
Robertson K:
AIDS Neurological Center Department of Neurology, University of North Carolina, Chapel Hill, NC, USA
Tan N:
Department of Engineering, Stanford University, Stanford, CA, USA
Mapesi H:
Ifakara branch, Ifakara Health Institute, Ifakara, Tanzania
Swiss Tropical and Public Health Institute, Basel, Switzerland
University of Basel, Basel, Switzerland
Samson L:
Ifakara branch, Ifakara Health Institute, Ifakara, Tanzania
St Francis Referral Hospital, Ifakara, Tanzania
Ndaki R:
Ifakara branch, Ifakara Health Institute, Ifakara, Tanzania
St Francis Referral Hospital, Ifakara, Tanzania
Battegay M:
Department of Infectious Diseases, University Hospital Basel, Basel, Switzerland
Division of Infectious Diseases and Hospital Epidemiology, University of Basel, Basel, Switzerland
Tanner M:
Swiss Tropical and Public Health Institute, Basel, Switzerland
University of Basel, Basel, Switzerland
Weisser M:
Ifakara branch, Ifakara Health Institute, Ifakara, Tanzania
Swiss Tropical and Public Health Institute, Basel, Switzerland
University of Basel, Basel, Switzerland
Dalmau D:
Infectious Diseases & HIV Service, Hospital Universitari MutuaTerrassa, Terrassa, Spain
University of Barcelona, Catalonia, Barcelona, Spain
Fundació per la Docència i Recerca MútuaTerrassa, Terrassa, Catalonia, Spain
Spanish HIV/AIDS Research Network of Excellence (RIS), Madrid, Spain
Letang E:
Ifakara branch, Ifakara Health Institute, Ifakara, Tanzania
Swiss Tropical and Public Health Institute, Basel, Switzerland
ISGlobal, Hospital Clínic-Universitat de Barcelona, Barcelona, Catalonia, Spain
Department of Infectious Diseases, Hospital del Mar, Hospital del Mar Research Institute (IMIM), Barcelona, Catalonia, Spain
Bronze
|