A-104 Gender and Neurocognitive Impairment among HIV Infected Individuals in Nigeria

Abstract

Background: Neurocognitive impairment (NCI) in HIV infection occurs as a frequent complication of HIV infection and, among HIV infected individuals in Nigeria, can be detected during the early stages of infection. The presence and severity of NCI can correlate with elevation of plasma levels of monocyte activation markers. In this study was examined the potential role of gender in the occurrence of NCI and associations between NCI and levels markers of HIV disease activity. Methods: One hundred thirty-three antiretroviral-naive seropositive (SP; 94 women and 59 men) and 56 seronegative (SN; 38 women and 18 men) participants received neuropsychological testing in 7 ability domains with calculation of demographically adjusted domain scores and a global deficit score (GDS). Also measured were plasma HIV RNA levels and plasma levels of the monocyte activation markers soluble CD163 and soluble CD14. Results: SP women in the study were younger than SP men, and SP women and men were less educated than their SN counterparts. CD4+ T cell counts, which were lower SP than for SN individuals, were higher for SN woman and SP women than for their male counterparts. Within the various ability domains, SP women scored worse than SN women with respect to verbal fluency and motor function and had higher overall mean GDS scores. In addition, SP women scored worse than SP men with respect to learning and memory. Mean log HIV viral load was higher and the frequency of non-detectable virus was lower for SP women than for SP men. Among SP women there was a borderline statistically significant correlation between sCD163 levels and GDS, and sCD14 levels were higher for impaired SP women than for non-impaired SP women. Viral load was higher for impaired SP men than non-impaired men and did not differ for impaired versus non-impaired SP women. Conclusions: Gender can have a significant impact on the occurrence of NCI among HIV infected individuals in Nigeria. This association appears to be linked to specific immune and viral factors, which require further study.