Neurocognitive Impairment Related to HIV Infection in Nigeria (P01.259)

Abstract

Objective: To examine outcomes on neuropsychological (NP) testing among individuals at risk for developing HIV-related neurocognitive impairment (NCI) in Nigeria. Background With 3.3 million infected, Nigeria has the 2 nd highest burden of HIV/AIDS. In the pre-antiretroviral therapy (ART) era up to 50% of infected individuals manifested NCI. In the context of expanded ART access in Nigeria and other low income countries understanding the prevalence and longitudinal impacts of NCI on patient outcomes is vital to sustainable programs. Design/Methods: ART-naive seropositive (SP) and seronegative (SN) control subjects are recruited at two antiretroviral treatment clinics in Nigeria. NP test data obtained at the time of study enrollment were analyzed. Multiple regression analyses were performed with HIV serological status, education, and ethnicity included as covariates. Effect sizes were determined by estimation of the Cohen9s d statistic. Results: 30 SP (23 in WHO stage I, four in stage II, three in stage III and one in stage IV) and 51 SN subjects were enrolled. The mean age and sex ratios were similar for the two groups; however, the SP group had a lower level of education (p=0.03). Significant relationships were found for HIV serostatus with performance on the overall NP battery (p=0.0096) and on tests of learning (p=0.0085), speed of information processing (p=0.01); executive function (p=0.01); and memory (p=0.02). Effect sizes for these analyses ranged between 0.34-0.36. On the full battery, 14 SP (46%) had scores >1 SD below the mean of the controls; of these, 7 (23%) had scores >2 SD below the mean. Ethnicity and education did not impact performance on the tests. Conclusions: HIV- related neurocognitive abnormalities were frequent in this patient group, who overall presented in the earlier stages of infection. Additional studies are underway to further define the clinical and virological associations for NCI with HIV infection in Nigeria. Supported by: National Institute of Mental Health, NIH. Disclosure: Dr. Royal has received personal compensation for activities with MedImpact Healthcare Systems, Inc.Dr. Royal received research support from EMD-Serono, Inc., Genzyme, Teva Neuroscience, Biogen and Novartis. Dr. Blattner has nothing to disclose. Dr. Cherner has nothing to disclose. Dr. Abimiku has nothing to disclose. Dr. Adebamowo has nothing to disclose. Dr. Johnson has nothing to disclose. Dr. Alabi has nothing to disclose. Dr. Alkali has nothing to disclose. Dr. Mamadu has nothing to disclose. Dr. Okwuasaba has nothing to disclose. Dr. Agala has nothing to disclose. Dr. Gupta has nothing to disclose. Dr. Hendrix has nothing to disclose. Dr. Eyzaguirre has nothing to disclose. Dr. Aragbada has nothing to disclose. Dr. Ojo has nothing to disclose. Dr. Adebiyi has nothing to disclose.