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HIV dementia alarmingly high in Africa

An international study led by Johns Hopkins suggests that the rate of HIV-associated dementia is so high in sub-Saharan Africa that HIV dementia along with Alzheimer’s disease and dementia from strokes may be among the most common forms of dementia in the world.

In the first study of HIV dementia on the African continent using rigorous neurological and neuropsychological tests, 31 percent of a small but presumably representative group of HIV-positive patients in Uganda were found to have HIV dementia, according to Ned Sacktor, M.D., a Johns Hopkins neurologist and senior author of a multi-institutional study that will be published Jan. 29 in Neurology.

HIV dementia is defined as memory, learning, behavioral and motor disabilities that interfere with normal daily life and in extreme cases lead to total disability and a bedridden state. Unlike Alzheimer’s- and stroke-induced dementia, HIV dementia is treatable and potentially reversible with the same antiretroviral medication that is used to treat the infection. Treatment can even restore completely normal cognitive function to some of those affected.

The study looked at 178 subjects in Kampala, Uganda, from September 2003 to January 2004. Seventy-eight were HIV-positive patients recruited from the Infectious Disease Clinic in Mulago Hospital, Makerere University, and 100 were HIV-negative individuals recruited from the AIDs Information Center who were used to obtain normative data for the cognitive tests.

In diagnosing HIV dementia, researchers looked at medical history and the results of a series of comprehensive neurological and neuropsychological tests and functional assessments.

"Clearly, large-scale testing would have to be conducted before we know the global reach of HIV dementia, but this study sends a clear message that it exists in high proportions in sub-Saharan Africa and is an under-recognized condition that needs to be studied and treated," Sacktor says. <
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Source:Johns Hopkins Medical Institutions


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