Neuropsychiatric HIV-1 infection study: in Kenya and Zaire cross-sectional phase I and II

Abstract

The objective of the study was to determine the prevalence and natural history of human immunodeficiency virus type 1 (HIV-1) associated psychiatric, neuropsychological and neurological abnormalities. A total of 408 subjects were recruited in Nairobi and Kinshasa. The study consisted of a cross sectional phase and a longitudinal follow up. Assessment was made by a data collection instrument including six modules. The intercentre and intracentre reliability in the use of the each module have been formally evaluated. The mean global score on the Montgomery-Asberg Depression Rating Scale was significantly higher in symptomatic seropositive individuals than in matched seronegative controls. In conclusion, these data suggest that the risk of subtle cognitive deficits may be increased in asymptomatic stages of HIV-1 infection.

PIP: Studies have shown an increased vulnerability to psychological distress and a significant prevalence of psychiatric disorders associated with HIV-1 infection, in the range of 30-63%. Infection with HIV-1 may also lead to a number of neurological complications, including AIDS dementia complex. The incidence of HIV-1 dementia is approximately 7 per 100 patients per year following the development of AIDS, with up to 20% of HIV-1-infected individuals receiving a diagnosis of HIV-1 dementia before death. A recent study, however, found no significant decline in cognitive functions before AIDS, unless overt dementia is present. To learn more about the prevalence and natural history of psychiatric, neuropsychological, and neurological complications of HIV-1 infection, the World Health Organization (WHO) conducted the WHO Neuropsychiatric AIDS Study. Findings are based upon the cross-sectional study and longitudinal follow-up of 203 subjects recruited in Nairobi, Kenya, and 205 in Kinshasa, Zaire. The author reports finding a significantly higher mean global score on the Montgomery-Asberg Depression Rating Scale in symptomatic HIV-seropositive individuals compared to in matched seronegative controls. Overall, the study data suggest that the risk of subtle cognitive deficits may be increased during the asymptomatic stages of HIV-1 infection.