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HIV-associated neurocognitive impairment in stable people living with HIV on ART in rural Tanzania
JournalArticle (Originalarbeit in einer wissenschaftlichen Zeitschrift)
ID
4646130
Author(s)
Sanmarti, M.; Meyer, A. C.; Jaen, A.; Robertson, K.; Tan, N.; Mapesi, H.; Samson, L.; Ndaki, R.; Battegay, M.; Tanner, M.; Weisser, M.; Dalmau, D.; Letang, E.; Kiularco Study Group,
HIV-associated neurocognitive impairment in stable people living with HIV on ART in rural Tanzania
Journal
HIV Med
Volume
22
Number
2
Pages / Article-Number
102-112
Keywords
Hiv; antiretroviral treatment; neurocognitive impairment; prevalence; rural; sub-Saharan Africa
Mesh terms
Adult; Anti-Retroviral Agents, therapeutic use; Cross-Sectional Studies; Female; HIV Infections, epidemiology; Humans; Male; Surveys and Questionnaires; Tanzania, epidemiology
Abstract
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.