Center for AIDS Research and Botswana-UPenn Partnership, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America.
PLoS One. 2011 Feb 18;6(2):e17233. doi: 10.1371/journal.pone.0017233.
To explore the prevalence and features of HIV-associated neurocognitive disorders (HANDS) in Botswana, a sub-Saharan country at the center of the HIV epidemic.
A cross sectional study of 60 HIV-positive individuals, all receiving highly active antiretroviral therapy (HAART), and 80 demographically matched HIV-seronegative control subjects. We administered a comprehensive neuropsychological test battery and structured psychiatric interview. The lowest 10(th) percentile of results achieved by control subjects was used to define the lower limit of normal performance on cognitive measures. Subjects who scored abnormal on three or more measures were classified as cognitively impaired. To determine the clinical significance of any cognitive impairment, we assessed medication adherence, employment, and independence in activities of daily living (ADL).
HIV+ subjects were impaired for all cognitive-motor ability areas compared with matched, uninfected control subjects. Thirty seven percent of HIV+ patients met criteria for cognitive impairment.
These findings indicate that neurocognitive impairment is likely to be an important feature of HIV infection in resource-limited countries; underscoring the need to develop effective treatments for subjects with, or at risk of developing, cognitive impairment.
探索博茨瓦纳（艾滋病流行中心的撒哈拉以南非洲国家）艾滋病毒相关神经认知障碍（HAND）的流行率和特征。
对 60 名接受高效抗逆转录病毒治疗（HAART）的 HIV 阳性个体和 80 名在人口统计学上匹配的 HIV 阴性对照个体进行横断面研究。我们进行了全面的神经心理学测试和结构化精神病学访谈。以对照组中获得的最低第 10 百分位数来定义认知测试的正常表现下限。在三个或更多测试中得分异常的个体被归类为认知障碍。为了确定任何认知障碍的临床意义，我们评估了药物依从性、就业和日常生活活动（ADL）的独立性。
与匹配的未感染对照个体相比，HIV+个体在所有认知运动能力领域均存在障碍。37%的 HIV+患者符合认知障碍标准。
这些发现表明，神经认知障碍可能是资源有限国家 HIV 感染的一个重要特征；强调需要为有认知障碍或有发展认知障碍风险的患者开发有效的治疗方法。
