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BMC Neurology  2007 

Pattern of neuropsychological performance among HIV positive patients in Uganda

DOI: 10.1186/1471-2377-7-8

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Abstract:

The neuropsychological test scores of 110 HIV positive patients (WHO Stage 2, n = 21; WHO Stage 3, n = 69; WHO Stage 4, n = 20) were contrasted with those of 100 control subjects on measures of attention/concentration, mental flexibility, learning/memory, and motor functioning.Analysis of covariance (ANCOVA) revealed significant group differences on measures of verbal learning and memory, speed of processing, attention and executive functioning between HIV seropositive and seronegative subjects.Ugandan patients with HIV demonstrated relative deficits on measures of verbal learning and memory, speed of processing, attention, and executive functioning compared to HIV negative controls. These results from a resource limited region where clades A and D are prevalent are consistent with previous findings in the developed world where clade B predominates.Studies done in the developed world in the era prior to highly active antiretroviral therapy (HAART) have shown prevalence rates of dementia ranging from 7.3%–27.3% in patients with advanced infection [1-3]. Despite the high prevalence of HIV in many African countries, very few studies have examined cognitive functioning in these patients. It cannot be assumed that HIV positive patients in Africa exhibit the same declines as patients in high-resource settings, since there are differences that may influence cognitive functioning including nutrition, history of concomitant disease, and varying HIV strains, among other possibilities.Cognitive impairments are relatively common in HIV infection. The most striking picture is of frank dementia. HIV associated dementia (HAD) afflicts 10–15% of patients with advanced infection in the United States [3], but there is also a high incidence of less severe dysfunction that has been labeled minor cognitive motor dysfunction (MCMD). HIV-associated cognitive impairment is found across all disease stages, with increasing rates of impairment with increasing systemic stage of HIV disease. Th

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