title: HIV subtype is not associated with dementia among individuals with moderate and advanced immunosuppression in Kampala, Uganda.
abstract: HIV-associated neurocognitive disorders (HAND) are a common neurological manifestation of HIV infection. A previous study suggested that HIV dementia may be more common among patients with subtype D virus than among those with subtype A virus among HIV+ individuals with advanced immunosuppression. We conducted a study to evaluate the frequency of HIV dementia, and the association of HIV dementia with HIV subtype and compartmentalization among HIV+ individuals with moderate and advanced immunosuppression (CD4 lymphocyte count >150 cells/μL and <250 cells/μL). The study enrolled 117 antiretroviral naïve HIV+ individuals in Kampala, Uganda. HIV+ individuals received neurological, neuropsychological testing, and functional assessments, and gag and gp41 regions were subtyped. Subjects were considered infected with a specific subtype if both regions analyzed were from the same subtype. 41% of the HIV+ individuals had HIV dementia (mean CD4 lymphocyte count = 233 cells/μL). 67 individuals had subtype A, 25 individuals had subtype D, 24 individuals were classified as A/D recombinants, and one individual had subtype C. There was no difference in the frequency of HIV dementia when stratified by HIV subtype A and D and no association with compartmentalization between the cerebrospinal fluid and peripheral blood. These results suggest that HIV dementia is common in HIV+ individuals in Uganda. There was no association between HIV subtype and dementia among HIV+ individuals with moderate and advanced immunosuppression. Future studies should be performed to confirm these results.
authors: Department of Neurology, Johns Hopkins Bayview Medical Center, 301 Building, Suite 2100, 4940 Eastern Ave., Baltimore, MD, 21224, USA, sacktor@jhmi.edu.
authors: Ned
authors: N
authors: Sacktor
authors: Noeline
authors: N
authors: Nakasujja
authors: Andrew D
authors: AD
authors: Redd
authors: Jordyn
authors: J
authors: Manucci
authors: Oliver
authors: O
authors: Laeyendecker
authors: Sarah K
authors: SK
authors: Wendel
authors: Stephen F
authors: SF
authors: Porcella
authors: Craig
authors: C
authors: Martens
authors: Daniel
authors: D
authors: Bruno
authors: Richard L
authors: RL
authors: Skolasky
authors: Ozioma C
authors: OC
authors: Okonkwo
authors: Kevin
authors: K
authors: Robertson
authors: Seggane
authors: S
authors: Musisi
authors: Elly
authors: E
authors: Katabira
authors: Thomas C
authors: TC
authors: Quinn
mesh_terms: D015526:AIDS Dementia Complex / Q000175:diagnosis* / Q000453:epidemiology / Q000235:genetics*; D000328:Adult; D018450:Disease Progression; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000453:epidemiology / Q000235:genetics; D015497:HIV-1 / Q000235:genetics* / Q000302:isolation & purification; D006801:Humans; D007108:Immune Tolerance / Q000235:genetics*; D008297:Male; D008875:Middle Aged; D010802:Phylogeny; D011795:Surveys and Questionnaires; D014454:Uganda / Q000453:epidemiology; D055815:Young Adult