Objective: To examine outcomes on neuropsychological (NP) testing among individuals at risk for HIV-related neurocognitive impairment (NCI) in Nigeria, where the burden of HIV/AIDS ranks second highest of all countries worldwide.
Methods: ART-naive seropositive (SP) and seronegative (SN) control subjects were recruited at two antiretroviral treatment clinics. 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 Cohen's d statistic.
Results: Eighty-one patients were administered the complete neuropsychological battery (31 SP and 50 SN). Among the SP group, 23 were WHO stage I, four were stage II, three were stage III and one was stage IV. The mean age and sex ratios were similar; however, the SP group had a lower level of education (p=0.03). No patients showed evidence of cognitive impairment. However, 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 treatment-naive patient group, who overall presented during the earlier stages of infection.
(C) 2013 Lippincott Williams & Wilkins, Inc.