Pattern of neuropsychological performance among HIV positive patients in Uganda
Department of Neurology, University of North Carolina School of Medicine, Chapel Hill, NC, United States; Department of Medicine, Makerere University, Kampala, Uganda; Department of Neurology, University of Virginia, Charlottesville, VA, United States; Center for Creative Technologies, University of Southern California, Marina del Ray, CA, United States; Department of Medicine, University of Manitoba, Winnipeg, MB, Canada; Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, United States
Background: Few studies have examined cognitive functioning of HIV positive patients in sub-Saharan Africa. 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. Part of the difficulty of specifying abnormalities in neuropsychological functioning among African HIV positive patients is that there are no readily available African normative databases. The purpose of the current study was to evaluate the pattern of neuropsychological performance in a sample of HIV positive patients in comparison to HIV negative control subjects in Uganda. Methods: 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. Results: 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. Conclusion: 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. © 2007 Robertson et al; licensee BioMed Central Ltd.
antiretrovirus agent; adult; analysis of covariance; article; attention; controlled study; dementia; developed country; female; highly active antiretroviral therapy; human; Human immunodeficiency virus infection; learning; major clinical study; male; memory; mental capacity; mental concentration; mental performance; motor performance; neuropsychological test; Uganda; acquired immune deficiency syndrome; analysis of variance; cognition; cognitive defect; disease course; Human immunodeficiency virus infection; middle aged; neuropsychological test; pathophysiology; physiology; psychological aspect; recall; statistics; Uganda; Adult; AIDS Dementia Complex; Analysis of Variance; Cognition; Cognition Disorders; Disease Progression; Female; HIV Infections; Humans; Male; Mental Recall; Middle Aged; Neuropsychological Tests; Uganda