Memory performance in HIV/AIDS--a prospective case control study.
BACKGROUND
Memory impairment, usually impaired retrieval of information, has been described in HIV/AIDS, especially among those with severe illness. Neuro-cognitive disturbances in HIV/AIDS have been linked to poor quality of life and medication adherence. This prospective, case-control study was designed to assess the verbal and non-verbal memory as well as the attention abilities of Nigerian Africans with HIV/AIDS and correlate their performances with their CD4+ T lymphocytes (CD4+) counts.


METHODS
A total of 288 randomly selected subjects, comprising 96 HIV-positive symptomatic patients, 96 HIV-positive asymptomatic patients and 96 HIV-negative controls, participated in the study. The subjects were age-, sex-, and level of education matched. The Recognition Memory Test and Choice Reaction Time tasks, components of the computer-assisted neuropsychological tests battery- the Iron Psychology 'FePsy' were used for cognitive assessments.


RESULTS
The mean memory scores of the HIV-positive asymptomatic subjects did not differ significantly from the controls (p > 0.05) but the HIV-positive symptomatic subjects' scores were significantly lower than the controls (p < 0.05). Both HIV-positive groups had psychomotor slowing and impaired attention (p < 0.05). The HIV-positive subjects with CD4+ counts < 200/microl and between 200 and 499/microl had significant memory impairment (p < 0.001 and p < 0.001 respectively) but there was no significant impairment among those with count > or = 500/microl. Impaired ability for sustained attention was however present irrespective of the CD4+ level relative to controls (p < 0.001).


CONCLUSIONS
We concluded that there was no significant memory disturbance among HIV-positive asymptomatic subjects despite the presence of impaired attention and psychomotor slowing, and that the severity of immune suppression (as indicated by the CD4+ T lymphocytes count) is a strong determinant of cognitive decline in HIV/AIDS.
Odiase
Francis E
FE
Neurology Unit, Department of Medicine, University of Benin Teaching Hospital, Benin City, Nigeria.
Ogunrin
Olubunmi A
OA
Ogunniyi
Adesola A
AA
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications*; D000328:Adult; D000704:Analysis of Variance; D018791:CD4 Lymphocyte Count; D016022:Case-Control Studies; D003071:Cognition / Q000502:physiology; D005260:Female; D006679:HIV Seropositivity / Q000150:complications; D006801:Humans; D008297:Male; D016555:Matched-Pair Analysis; D008569:Memory Disorders / Q000175:diagnosis / Q000209:etiology*; D008875:Middle Aged; D009483:Neuropsychological Tests; D016017:Odds Ratio; D011446:Prospective Studies; D011930:Reaction Time / Q000502:physiology; D021641:Recognition, Psychology / Q000502:physiology*; D014705:Verbal Behavior / Q000502:physiology; D014706:Verbal Learning / Q000502:physiology*