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From the School of Medicine (M.H.W.), McMaster University, Hamilton, Ontario, Canada; Department of Neurology (K.R.), University of North Carolina School of Medicine, Chapel Hill, NC; Departments of Neurology (N.S., J.C.M.) and Orthopedics (R.S.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Medicine (N.N., S.M., E.K.), Makerere University, Kampala, Uganda; and the Department of Medicine (A.R.), University of Manitoba, Winnipeg, MB, Canada.
Address correspondence and reprint requests to: Dr. Matthew Wong, Department of Neurology, University of Virginia Health System, PO Box 800394, Charlottesville, VA, 22908; e-mail: mhw9e{at}virginia.edu
Objective: To measure the frequency and associated risk factors of HIV dementia in an HIV clinic in Kampala, Uganda.
Methods: We systematically sampled 78 HIV-seropositive (HIV+) patients from an ambulatory HIV clinic. Participants underwent detailed sociodemographic, medical history, functional, neurologic, and neuropsychological evaluations. One hundred HIV-negative patients were recruited to provide normative data for the neuropsychological tests. A logistic regression model was constructed to determine risk factors associated with the diagnosis of HIV dementia.
Results: Thirty-one percent (24 of 78) of the HIV+ patients had HIV dementia. Advanced age and low CD4+ T-lymphocyte count (CD4 count) were the only variables identified as significant risk factors in the logistic regression model. Each additional 10 years of age conferred a greater than twofold risk of HIV dementia (OR 2.06, 95% CI: 1.05 to 4.07; p < 0.05). Reduced levels of CD4 count (100 cells/µL decrement) was associated with a 60% increase in the odds of having HIV dementia (OR 1.6, 95% CI: 1.04 to 2.33; p < 0.05).
Conclusion: HIV dementia is common in HIV-seropositive Ugandan individuals attending an AIDS clinic. It is more frequently associated with patients of advanced age and decreased CD4 count.
See also page 324
Supported by NS044807, NS049465, NS36519, MH070056, 1P30MH075673, and MH71150; the Canadian Institutes of Health Research; the Bill and Melinda Gates Foundation; and the Academic Alliance Foundation (which has received support from Pfizer Pharmaceuticals).
Disclosures: Dr. Matthew Wong received funding from the Canadian Institutes of Health Research. Dr. Kevin Robertson has reported no conflicts of interest. Dr. Noeline Nakasujja has reported no conflicts of interest. Dr. Seggane Musisi has reported no conflicts of interest. Dr. Elly Katabira has reported no conflicts of interest. Dr. Justin McArthur receives grant funding from NINDS (NS 44807 and NS049465) and from NIMH (MH070056 and MH075673), has been an unpaid consultant to Savient, and has Gliamed stock options (advisory board). Dr. Allan Ronald receives a stipend from Academic Alliance Foundation. This foundation is the recipient of grants from many pharmaceutical corporations including Pfizer Pharmaceutical Corporation, Gilead, and other corporate donors. Dr. Ned Sacktor has reported no conflicts of interest.
Received May 12, 2006. Accepted in final form October 30, 2006.
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