Neurocognitive impairment in treatment-experienced adults living with HIV attending primary care clinics in Zimbabwe

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dc.contributor.authorNyamayaro, Primrose
dc.contributor.authorGouse, Hetta
dc.contributor.authorHakim, James
dc.contributor.authorRobbins, Reuben N
dc.contributor.authorChibanda, Dixon
dc.date.accessioned2020-06-10T08:54:46Z
dc.date.available2020-06-10T08:54:46Z
dc.date.issued2020-05-29
dc.date.updated2020-05-31T03:15:25Z
dc.description.abstractBackground HIV affects the central nervous system resulting in HIV associated neurocognitive impairment (NCI) in approximately 50% of people living with HIV. It typically affects memory, learning, working memory, fine motor skills, speed of information processing, verbal fluency and executive functioning cognitive domains. NCI can affect adherence to antiretroviral therapy (ART), employability, driving ability and activities of daily living. NCI is not routinely screened for in Zimbabwe, and the burden is not known in this setting. The objectives of this study were: 1) To determine NCI prevalence using a comprehensive neuropsychological battery at two primary health care clinics in Harare; 2) To assess the pattern of cognitive impairment across cognitive domains using a gold standard neuropsychological (NP) battery in HIV-positive patients compared to HIV-negative controls. Methods Inclusion criteria: 18 years or older; minimum 7 years education; no neurological or psychiatric disorders. HIV-positive participants were on ART for ≥3 months; HIV-negative participants had a confirmed HIV negative status in the past month. A comprehensive NP battery, functional assessments, demographic and medical history questionnaires were administered. The NP battery consisted of tests assessing memory, learning, working memory, fine motor skills, speed of information processing, verbal fluency and executive functioning. Results Two-hundred-and-thirty-one participants were recruited. Of those, 155 were HIV-positive (Female = 70%, Age M = 37.8; SD 11.2) and 76 HIV-negative (Female = 63%, Age M = 31.2; SD 9.9). HIV-positive participants were on ART for an average of 6 years. NCI was present in 49.7% HIV positive participants. Compared to HIV-negative participants, the HIV-positive group had significantly poorer scores in 5 out of 7 cognitive domains. A good level of education is negatively correlated with NCI. Conclusions NCI prevalence in HIV-positive population Zimbabwe is consistent with global estimates. NCI persists in adults who are on ART. Routine assessment of NCI in adults attending primary care clinics using this adapted battery is therefore important so that they are identified early and are provided the necessary interventions.en_US
dc.identifier.apacitationNyamayaro, P., Gouse, H., Hakim, J., Robbins, R. N., & Chibanda, D. (2020). Neurocognitive impairment in treatment-experienced adults living with HIV attending primary care clinics in Zimbabwe. <i>BMC Infectious Diseases</i>, 20(1), 383. http://hdl.handle.net/11427/32059en_ZA
dc.identifier.chicagocitationNyamayaro, Primrose, Hetta Gouse, James Hakim, Reuben N Robbins, and Dixon Chibanda "Neurocognitive impairment in treatment-experienced adults living with HIV attending primary care clinics in Zimbabwe." <i>BMC Infectious Diseases</i> 20, 1. (2020): 383. http://hdl.handle.net/11427/32059en_ZA
dc.identifier.citationNyamayaro, P., Gouse, H., Hakim, J., Robbins, R.N. & Chibanda, D. 2020. Neurocognitive impairment in treatment-experienced adults living with HIV attending primary care clinics in Zimbabwe. <i>BMC Infectious Diseases.</i> 20(1):383. http://hdl.handle.net/11427/32059en_ZA
dc.identifier.ris TY - Journal Article AU - Nyamayaro, Primrose AU - Gouse, Hetta AU - Hakim, James AU - Robbins, Reuben N AU - Chibanda, Dixon AB - Background HIV affects the central nervous system resulting in HIV associated neurocognitive impairment (NCI) in approximately 50% of people living with HIV. It typically affects memory, learning, working memory, fine motor skills, speed of information processing, verbal fluency and executive functioning cognitive domains. NCI can affect adherence to antiretroviral therapy (ART), employability, driving ability and activities of daily living. NCI is not routinely screened for in Zimbabwe, and the burden is not known in this setting. The objectives of this study were: 1) To determine NCI prevalence using a comprehensive neuropsychological battery at two primary health care clinics in Harare; 2) To assess the pattern of cognitive impairment across cognitive domains using a gold standard neuropsychological (NP) battery in HIV-positive patients compared to HIV-negative controls. Methods Inclusion criteria: 18 years or older; minimum 7 years education; no neurological or psychiatric disorders. HIV-positive participants were on ART for ≥3 months; HIV-negative participants had a confirmed HIV negative status in the past month. A comprehensive NP battery, functional assessments, demographic and medical history questionnaires were administered. The NP battery consisted of tests assessing memory, learning, working memory, fine motor skills, speed of information processing, verbal fluency and executive functioning. Results Two-hundred-and-thirty-one participants were recruited. Of those, 155 were HIV-positive (Female = 70%, Age M = 37.8; SD 11.2) and 76 HIV-negative (Female = 63%, Age M = 31.2; SD 9.9). HIV-positive participants were on ART for an average of 6 years. NCI was present in 49.7% HIV positive participants. Compared to HIV-negative participants, the HIV-positive group had significantly poorer scores in 5 out of 7 cognitive domains. A good level of education is negatively correlated with NCI. Conclusions NCI prevalence in HIV-positive population Zimbabwe is consistent with global estimates. NCI persists in adults who are on ART. Routine assessment of NCI in adults attending primary care clinics using this adapted battery is therefore important so that they are identified early and are provided the necessary interventions. DA - 2020-05-29 DB - OpenUCT DP - University of Cape Town IS - 1 J1 - BMC Infectious Diseases KW - Neurocognitive impairment KW - HIV KW - Treatment-experienced KW - Neuropsychological assessment LK - https://open.uct.ac.za PY - 2020 T1 - Neurocognitive impairment in treatment-experienced adults living with HIV attending primary care clinics in Zimbabwe TI - Neurocognitive impairment in treatment-experienced adults living with HIV attending primary care clinics in Zimbabwe UR - http://hdl.handle.net/11427/32059 ER - en_ZA
dc.identifier.urihttps://doi.org/10.1186/s12879-020-05090-8
dc.identifier.urihttp://hdl.handle.net/11427/32059
dc.identifier.vancouvercitationNyamayaro P, Gouse H, Hakim J, Robbins RN, Chibanda D. Neurocognitive impairment in treatment-experienced adults living with HIV attending primary care clinics in Zimbabwe. BMC Infectious Diseases. 2020;20(1):383. http://hdl.handle.net/11427/32059.en_ZA
dc.language.rfc3066en
dc.publisher.departmentDepartment of Psychiatry and Mental Healthen_US
dc.publisher.facultyFaculty of Health Sciencesen_US
dc.rights.holderThe Author(s)
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/en_US
dc.sourceBMC Infectious Diseasesen_US
dc.source.journalissue1en_US
dc.source.journalvolume20en_US
dc.source.pagination383en_US
dc.source.urihttps://bmcinfectdis.biomedcentral.com/
dc.subjectNeurocognitive impairmenten_US
dc.subjectHIVen_US
dc.subjectTreatment-experienceden_US
dc.subjectNeuropsychological assessmenten_US
dc.titleNeurocognitive impairment in treatment-experienced adults living with HIV attending primary care clinics in Zimbabween_US
dc.typeJournal Articleen_US
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