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2. Lack of Association of Vascular Risk Factors with HIV-Associated Neurocognitive Disorders in cART-Treated Adults Aged ≥ 50 Years in Tanzania

Author

Flack, Katherine A., primary, Rainey, Emma S., additional, Urasa, Sarah J., additional, Koipapi, Sengua, additional, Kalaria, Rajesh N., additional, Howlett, William P., additional, Mukaetova-Ladinska, Elizabeta B., additional, Dekker, Marieke C. J., additional, Gray, William K., additional, Walker, Richard W., additional, Dotchin, Catherine L., additional, Mtwaile, Himidi, additional, Lewis, Thomas C. D., additional, Stone, Lydia G., additional, McNally, Richard J. Q., additional, Makupa, Philip C., additional, and Paddick, Stella-Maria, additional

Published
2024
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3. HIV-Associated Neurocognitive Disorders: The First Longitudinal Follow-Up of a cART-Treated Cohort of Older People in Sub-Saharan Africa

Author

Spooner, Rebecca, primary, Ranasinghe, Sherika, additional, Urasa, Sarah, additional, Yoseph, Marcella, additional, Koipapi, Sengua, additional, Mukaetova-Ladinska, Elizabeta B., additional, Lewis, Thomas, additional, Howlett, William, additional, Dekker, Marieke, additional, Kisoli, Aloyce, additional, Gray, William K., additional, Walker, Richard W., additional, Dotchin, Catherine L., additional, Kalaria, Raj, additional, Lwezuala, Bingileki, additional, Makupa, Philip C., additional, Akinyemi, Rufus, additional, and Paddick, Stella M., additional

Published
2022
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4. Prevalence and 1-year incidence of HIV-associated neurocognitive disorder (HAND) in adults aged ≥50 years attending standard HIV clinical care in Kilimanjaro, Tanzania

Author

Flatt, Aidan, primary, Gentry, Tom, additional, Kellett-Wright, Johanna, additional, Eaton, Patrick, additional, Joseph, Marcella, additional, Urasa, Sarah, additional, Howlett, William, additional, Dekker, Marieke, additional, Kisoli, Aloyce, additional, Rogathe, Jane, additional, Henderson, Lindsay, additional, Lewis, Thomas, additional, Thornton, Jessica, additional, McCartney, Judith, additional, Yarwood, Vanessa, additional, Irwin, Charlotte, additional, Mukaetova-Ladinska, Elizabeta B., additional, Akinyemi, Rufus, additional, Gray, William K., additional, Walker, Richard W., additional, Dotchin, Catherine L., additional, Quaker, Andrew-Leon S., additional, Makupa, Philip C., additional, and Paddick, Stella-Maria, additional

Published
2021
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5. Prevalence and 1-year incidence of HIV-associated neurocognitive disorder (HAND) in adults aged ≥50 years attending standard HIV clinical care in Kilimanjaro, Tanzania.

Author

Flatt A, Gentry T, Kellett-Wright J, Eaton P, Joseph M, Urasa S, Howlett W, Dekker M, Kisoli A, Rogathe J, Henderson L, Lewis T, Thornton J, McCartney J, Yarwood V, Irwin C, Mukaetova-Ladinska EB, Akinyemi R, Gray WK, Walker RW, Dotchin CL, Quaker AS, Makupa PC, and Paddick SM

Subjects
Humans, Female, Aged, Male, HIV, Incidence, Prevalence, Longitudinal Studies, Tanzania epidemiology, Cross-Sectional Studies, Neurocognitive Disorders diagnosis, Neurocognitive Disorders epidemiology, Neuropsychological Tests, HIV Infections complications, HIV Infections drug therapy, HIV Infections epidemiology, AIDS Dementia Complex epidemiology
Abstract

Objectives: 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., Design: Longitudinal study., Participants: A systematic 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., Measurements: 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., Results: 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., Conclusions: 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.

Published
2023
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