Effects of HIV infection, antiretroviral therapy, and immune status on the speed of information processing and complex motor functions in adult Cameroonians

Georgette D Kanmogne,Bin Tang,Dora M Njamnshi,Alfred K Njamnshi,Anya Umlauf,Julius Y Fonsah,Roland F Doh,Robert K Heaton,Anne M Kengne,Emilienne Nchindap,Jacob Moul,Donald Franklin,Dora Mbanya,Claude T Tagny,Callixte T Kuate,Léopoldine Kenmogne

doi:10.1038/s41598-020-70981-4

Abstract

HIV-associated neurocognitive deficits include impaired speed-of-information processing (SIP) and motor functions. There is lack of Cameroonian adult norms for assessing SIP or motor functions. This study of 683 Cameroonians (320 HIV+, 363 HIV−) establishes demographically-adjusted norms for six SIP [Wechsler-Adult-Intelligence-Scale (WAIS)-III Digit Symbol (WAIS-IIIDS) and Symbol Search (WAIS-IIISS), Stroop Color-Naming, Stroop Word-Reading, Trail-Making Test-A (TMT-A), Color Trails-1 (CTT1)], and two motor function [Grooved Pegboard-dominant (GP-DH) and non-dominant (GP-NDH) hands] tests. We assessed viral effects on SIP and motor functions. HIV-infected persons had significantly lower (worse) T scores on GP-DH, WAIS-IIIDS, Stroop Word-Reading, TMT-A; lower motor and SIP summary T scores. Significantly higher proportion of cases (20.7%) than controls (10.3%) had impaired SIP. Male cases had better T scores than female cases on GP-NDH, WAIS-IIIDS, WAIS-IIISS, TMT-A, CTT1; better SIP summary T scores. Antiretroviral therapy (ART) was associated with significantly better T scores on GP-NDH, WAIS-IIIDS, Stroop Color-Naming; better motor and SIP summary T scores. Cases with higher CD4 had better T scores on WAIS-IIIDS, TMT-A, CTT1; better SIP summary T scores. Overall, we demonstrate that HIV infection in Cameroon is associated with deficits in SIP and motor functions; ART and higher CD4 are associated with better cognitive performance. We provide SIP and psychomotor functions normative standards, which will be useful for neurobehavioral studies in Cameroon of diseases affecting the brain.

Highlights

HIV-associated neurocognitive deficits include impaired speed-of-information processing (SIP) and motor functions
The participants ranged in age from 18 to 64 years, with majority being females (71.3%) and the number of years of formal education ranged from 0 to 21 years
The HIV+ cases had a median CD4 cell count of 405 cells/μl, the majority were on Antiretroviral therapy (ART) (53.6%) and had controlled viremia (57.2% had undetectable viral loads (VL)) (Table 1)

Summary

Introduction

HIV-associated neurocognitive deficits include impaired speed-of-information processing (SIP) and motor functions. Diseases that affect the central nervous system (CNS) often result in impaired cognition This is the case for HIV/AIDS, where in the early stages of infection, the virus induces blood–brain barrier injury, enters the CNS, and productively infects resident macrophages and glial c ells[1,2]. This infection of CNS cells, production and release of HIV virions and viral proteins into the brain, as well as subsequent increased inflammation and oxidative stress, can cause neuronal injury and death, and result in behavioral, motor and cognitive abnormalities termed HIV-associated neurocognitive disorders (HAND)[2,3,4]. Population-appropriate normative standards for these NP measures are critical to accurately assess the neurobehavioral effects of HIV infection

Objectives

Methods

Results

Conclusion