College Research and Innovation Hub, Ibadan, Nigeria.
College of Medicine University of Ibadan, Ibadan, Nigeria.
AIDS Res Ther. 2024 Nov 28;21(1):88. doi: 10.1186/s12981-024-00677-6.
The impact of Human Immunodeficiency Virus (HIV) on neurocognition in Africa is a pressing public health issue, with profound implications for both individual well-being and healthcare systems across the continent. This narrative review aims to elucidate the intricate relationship between HIV infection and neurocognitive function, particularly focusing on HIV-associated neurocognitive disorders (HAND), the effects of antiretroviral therapy (ART), and neuropathological changes. Evidence from Africa emphasizes the variability in the prevalence of neurocognitive impairment among people living with HIV. For instance, a meta-analysis showed that Central and South Africa had the highest pooled prevalence of neurocognitive impairment (NCI) (49.33%), followed by East Africa (45.04%) and West Africa (42.40%). These differences may reflect varying ART coverage, healthcare infrastructure, and the prevalence of co-infections like tuberculosis highlighting the importance of region-specific interventions and support services tailored to local contexts. Furthermore, challenges such as late diagnosis, methodological variations, treatment non-adherence, and limited access to specialized care exacerbate the burden of neurocognitive impairment in this setting. Addressing the complex intersection of HIV and neurocognition in Africa requires a multifaceted approach involving various stakeholders, including healthcare providers, policymakers, researchers, and community organizations. Enhancing awareness, education, and capacity- building initiatives can improve early detection and management of neurocognitive disorders among individuals living with HIV. Moreover, investment in infrastructure and resources for neurocognitive care, including diagnostic tools and rehabilitation services, is essential to meet the growing needs of this population. Additionally, promoting research collaboration and knowledge exchange is important for advancing our understanding of HIV-related neurocognitive impairment and developing evidence-based interventions. By fostering partnerships between academia, healthcare institutions, and governmental agencies, we can facilitate the translation of research findings into policy and practice, ultimately improving outcomes and quality of life for individuals affected by HAND in Africa.
艾滋病毒（HIV）对非洲神经认知的影响是一个紧迫的公共卫生问题，对整个非洲大陆的个人福祉和医疗保健系统都有深远的影响。本叙事性综述旨在阐明 HIV 感染与神经认知功能之间的复杂关系，特别是重点关注 HIV 相关神经认知障碍（HAND）、抗逆转录病毒疗法（ART）的影响和神经病理学变化。非洲的证据强调了艾滋病毒感染者中神经认知障碍的流行率存在差异。例如，一项荟萃分析显示，中南非地区的神经认知障碍（NCI）总体患病率最高（49.33%），其次是东非（45.04%）和西非（42.40%）。这些差异可能反映了不同的 ART 覆盖率、医疗保健基础设施以及结核等合并感染的流行率，这突出了针对特定区域的干预措施和支持服务的重要性，这些服务需要根据当地情况进行定制。此外，晚期诊断、方法学差异、治疗不依从以及获得专门护理的机会有限等挑战，加剧了非洲这一环境中神经认知障碍的负担。在非洲解决 HIV 和神经认知之间的复杂交叉问题需要采取多方面的方法，涉及包括医疗保健提供者、政策制定者、研究人员和社区组织在内的各种利益相关者。增强意识、教育和能力建设举措可以提高艾滋病毒感染者中神经认知障碍的早期检测和管理水平。此外，为神经认知护理投资基础设施和资源，包括诊断工具和康复服务，对于满足这一人群不断增长的需求至关重要。此外，促进研究合作和知识交流对于深入了解 HIV 相关神经认知障碍和开发基于证据的干预措施至关重要。通过促进学术界、医疗机构和政府机构之间的伙伴关系，我们可以促进研究成果转化为政策和实践，最终改善非洲 HAND 患者的预后和生活质量。
