ArticleJournal of acquired immune deficiency syndromes (1999)2019
Effect of HIV Subtype and Antiretroviral Therapy on HIV-Associated Neurocognitive Disorder Stage in Rakai, Uganda.
Article in Journal of acquired immune deficiency syndromes (1999), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 3 of them syntheses that pooled it.
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Who cites it
18 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Prevalence and variability of HIV/AIDS-associated neurocognitive impairments in Africa: a systematic review and meta-analysis.BMC public health · 2023Pooled it
- Aging with HIV in Latin America and the Caribbean: a Systematic Review.Current HIV/AIDS reports · 2021Pooled it
- The Impact of Antiretroviral Therapy on Neurocognitive Outcomes Among People Living with HIV in Low- and Middle-Income Countries (LMICs): A Systematic Review.AIDS and behavior · 2021Pooled it
- HIV-1 subtype diversity in the pathogenesis of neuroHIV.Nature reviews. Neuroscience · 2026Article
- International application of an optimized harmonization approach for longitudinal cognitive data in people with HIV.Journal of clinical epidemiology · 2025Article
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- Article
- Triple Burden of Neurocognitive Impairment and Co-occurring Depression and Anxiety Among People Living With HIV in Bahir Dar, Ethiopia: A Multicenter Study.Frontiers in psychiatry · 2022Article
- Assessment, prevalence, and correlates of frailty among middle-aged adults with HIV in rural Uganda.Journal of neurovirology · 2021Article
- Visual Impairment and Eye Diseases in HIV-infected People in the Antiretroviral Therapy (ART) Era in Rakai, Uganda.Ophthalmic epidemiology · 2021Article
- Prevalence of Severe Neurocognitive Impairment and Its Association with Socio-Demographics and Functionality Among Ugandan Older Persons: A Hospital-Based Study.Clinical interventions in aging · 2021Article
- Characterization of HIV-Associated Neurocognitive Impairment in Middle-Aged and Older Persons With HIV in Lima, Peru.Frontiers in neurology · 2021Article
- Effects of HIV infection, antiretroviral therapy, and immune status on the speed of information processing and complex motor functions in adult Cameroonians.Scientific reports · 2020Article
- Cumulative Burden of Depression and Neurocognitive Decline Among Persons With HIV: A Longitudinal Study.Journal of acquired immune deficiency syndromes (1999) · 2020Article
- Attention/Working Memory, Learning and Memory in Adult Cameroonians: Normative Data, Effects of HIV Infection and Viral Genotype.Journal of the International Neuropsychological Society : JINS · 2020Article
- The Veterans Aging Cohort Study Index is not associated with HIV-associated neurocognitive disorders in Uganda.Journal of neurovirology · 2020Article
- Utility of the International HIV Dementia Scale for HIV-Associated Neurocognitive Disorder.Journal of acquired immune deficiency syndromes (1999) · 2020Observational
- The Intersection of Cognitive Ability and HIV: A Review of the State of the Nursing Science.The Journal of the Association of Nurses in AIDS Care : JANACReview
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12 authors.
Funding
Abstract
backgroundCombination antiretroviral therapy (ART) improves HIV-associated neurocognitive disorder (HAND) stage in the United States where subtype B predominates, but the effect of ART and subtype on HAND stage in individuals in Uganda with subtypes D and A is largely unknown.
settingA community-based cohort of participants residing in Rakai, Uganda.
methodsThree hundred ninety-nine initially ART-naive HIV-seropositive (HIV+) individuals were followed up over 2 years. Neurological and neuropsychological tests and functional assessments were used to determine HAND stage. Frequency and predictors of HAND and HIV-associated dementia (HAD) were assessed at baseline and at follow-up after ART initiation in 312 HIV+ individuals. HIV subtype was determined from gag and env sequences.
resultsAt 2-year follow-up, HAD frequency among HIV+ individuals on ART (n = 312) decreased from 13% to 5% (P < 0.001), but the overall frequency of HAND remained unchanged (56%-51%). Subtype D was associated with higher rates of impaired cognition (global deficit score ≥ 0.5) compared with HIV+ individuals with subtype A (55% vs. 24%) (P = 0.008). Factors associated with HAD at baseline were older age, depression, and plasma HIV viral load >100,000 copies/mL. At follow-up, age and depression remained significantly associated with HAD.
conclusionsHIV+ individuals on ART in rural Uganda had a significant decrease in the frequency of HAD, but HAND persists after 2 years on ART. The current guideline of immediate ART initiation after HIV diagnosis is likely to greatly reduce HAD in sub-Saharan Africa. Further studies of the effect of HIV subtype and neurocognitive performance are warranted.
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