title: Antiretroviral therapy improves cognitive impairment in HIV+ individuals in sub-Saharan Africa.
abstract: BACKGROUND
  Highly active antiretroviral therapy (HAART) can improve cognitive performance in some patients with HIV-associated cognitive impairment in the United States. The effect of HAART on HIV dementia in sub-Saharan Africa is largely unknown.
  
  
  OBJECTIVE
  To evaluate neuropsychological test and functional performance in HIV+ individuals after 3 and 6 months of HAART in Uganda.
  
  
  METHODS
  Twenty-three HIV+ individuals receiving HAART also received a detailed clinical history, neuropsychological testing, and a functional assessment. Follow-up evaluations were performed at 3 and 6 months after baseline. Longitudinal changes in the HIV dementia stage, the mean Z score for each neuropsychological test, and the Karnofsky Functional Performance Scale were evaluated at 3 and 6 months.
  
  
  RESULTS
  The mean (SD) CD4 cell count improved from 71 (15) at baseline to 161 (30) at 3 months (p = 0.005) and 222 (46) at 6 months (p < 0.001). Improvements were found in the Memorial Sloan Kettering HIV dementia stage and in tests of verbal memory, psychomotor speed, and executive functioning after 3 and 6 months of HAART (p < 0.001 at 6 months for each neuropsychological test). There was also improvement in the Karnofsky Functional Performance Scale at both 3 and 6 months after the initiation of HAART (p < 0.001).
  
  
  CONCLUSIONS
  Highly active antiretroviral therapy (HAART) can be associated with improvement in neurocognitive and functional performance in HIV+ individuals in sub-Saharan Africa. These results suggest that HAART, if available in areas with limited resources in sub-Saharan Africa, should be provided for patients with HIV-associated cognitive impairment.
authors.affiliation: Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA. sacktor@jhmi.edu
authors.forename: N
authors.initials: N
authors.lastname: Sacktor
authors.forename: N
authors.initials: N
authors.lastname: Nakasujja
authors.forename: R
authors.initials: R
authors.lastname: Skolasky
authors.forename: K
authors.initials: K
authors.lastname: Robertson
authors.forename: M
authors.initials: M
authors.lastname: Wong
authors.forename: S
authors.initials: S
authors.lastname: Musisi
authors.forename: A
authors.initials: A
authors.lastname: Ronald
authors.forename: E
authors.initials: E
authors.lastname: Katabira
mesh_terms: D000328:Adult; D017954:Africa South of the Sahara / Q000453:epidemiology; D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active / Q000706:statistics & numerical data*; D003072:Cognition Disorders / Q000453:epidemiology* / Q000517:prevention & control*; D015897:Comorbidity; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000453:epidemiology*; D006801:Humans; D008297:Male; D015995:Prevalence; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D044966:Anti-Retroviral Agents