Internet Archive Scholar

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

Aidan Flatt, Tom Gentry, Johanna Kellett-Wright, Patrick Eaton, Marcella Joseph, Sarah Urasa, William Howlett, Marieke Dekker, Aloyce Kisoli, Jane Rogathe, Lindsay Henderson, Thomas Lewis (+12 others)
2021 International Psychogeriatrics  

Preserved Fulltext

fulltext thumbnail
Web Archive Capture PDF (342.8 kB)
https://web.archive.org/web/20210410150833/https://www.cambridge.org/core/services/aop-cambridge-core/content/view/08C078994ABAFB271CBD0152BD5DFE63/S1041610221000156a.pdf/div-class-title-prevalence-and-1-year-incidence-of-hiv-associated-neurocognitive-disorder-hand-in-adults-aged-50-years-attending-standard-hiv-clinical-care-in-kilimanjaro-tanzania-div.pdf

A copy of this work was available on the public web and has been preserved in the Wayback Machine. The capture dates from 2021; you can also visit the original URL. The file type is application/pdf.

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
more » ... stematic 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.
doi:10.1017/s1041610221000156 pmid:33757616 fatcat:euv6uhifzvbdnn57fe3eox7u6y
Citation

Aidan Flatt, Tom Gentry, Johanna Kellett-Wright, Patrick Eaton, Marcella Joseph, Sarah Urasa, William Howlett, Marieke Dekker, Aloyce Kisoli, Jane Rogathe, Lindsay Henderson, Thomas Lewis, Jessica Thornton, Judith McCartney, Vanessa Yarwood, Charlotte Irwin, Elizabeta B Mukaetova-Ladinska, Rufus Akinyemi, William K Gray, Richard W Walker, Catherine L Dotchin, Andrew-Leon S Quaker, Philip C Makupa, Stella-Maria Paddick. "Prevalence and 1-year incidence of HIV-associated neurocognitive disorder (HAND) in adults aged ≥50 years attending standard HIV clinical care in Kilimanjaro, Tanzania." International Psychogeriatrics (2021) 1-12