Details

Autor(en) / Beteiligte

• Flatt, Aidan
• Gentry, Tom
• Kellett-Wright, Johanna
• Eaton, Patrick
• Joseph, Marcella
• Urasa, Sarah
• Howlett, William
• Dekker, Marieke
• Kisoli, Aloyce
• Rogathe, Jane
• Henderson, Lindsay
• Lewis, Thomas
• Thornton, Jessica
• McCartney, Judith
• Yarwood, Vanessa
• Irwin, Charlotte
• Mukaetova-Ladinska, Elizabeta B
• Akinyemi, Rufus
• Gray, William K
• Walker, Richard W
• Dotchin, Catherine L
• Quaker, Andrew-Leon S
• Makupa, Philip C
• Paddick, Stella-Maria

Titel

Prevalence and 1-year incidence of HIV-associated neurocognitive disorder (HAND) in adults aged ≥50 years attending standard HIV clinical care in Kilimanjaro, Tanzania

Ist Teil von

• International psychogeriatrics, 2023-07, Vol.35 (7), p.339-350

Ort / Verlag

England: Cambridge University Press

Erscheinungsjahr

2023

Link zum Volltext

Quelle

Applied Social Sciences Index & Abstracts (ASSIA)

Beschreibungen/Notizen

• HIV-associated neurocognitive disorders (HANDs) are prevalent in older people living with HIV (PLWH) worldwide. HAND prevalence and incidence studies of the newly emergent population of combination antiretroviral therapy (cART)-treated older PLWH in sub-Saharan Africa are currently lacking. We aimed to estimate HAND prevalence and incidence using robust measures in stable, cART-treated older adults under long-term follow-up in Tanzania and report cognitive comorbidities. Longitudinal study. A systematic sample of consenting HIV-positive adults aged ≥50 years attending routine clinical care at an HIV Care and Treatment Centre during March-May 2016 and followed up March-May 2017. HAND by consensus panel Frascati criteria based on detailed locally normed low-literacy neuropsychological battery, structured neuropsychiatric clinical assessment, and collateral history. Demographic and etiological factors by self-report and clinical records. In this cohort (n = 253, 72.3% female, median age 57), HAND prevalence was 47.0% (95% CI 40.9-53.2, n = 119) despite well-managed HIV disease (Mn CD4 516 (98-1719), 95.5% on cART). Of these, 64 (25.3%) were asymptomatic neurocognitive impairment, 46 (18.2%) mild neurocognitive disorder, and 9 (3.6%) HIV-associated dementia. One-year incidence was high (37.2%, 95% CI 25.9 to 51.8), but some reversibility (17.6%, 95% CI 10.0-28.6 n = 16) was observed. HAND appear highly prevalent in older PLWH in this setting, where demographic profile differs markedly to high-income cohorts, and comorbidities are frequent. Incidence and reversibility also appear high. Future studies should focus on etiologies and potentially reversible factors in this setting.