Abstract no. WEPDB0104 JC Mogambery1, H Dawood2, D Wilson3, A Moodley4

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Presentation transcript:

Abstract no. WEPDB0104 JC Mogambery1, H Dawood2, D Wilson3, A Moodley4 1 Grey’s Hospital, Infectious Disease Unit, UKZN 2 Grey’s Hospital, Infectious Disease Unit, UKZN, CAPRISA 3 Edendale Hospital, Department of Internal Medicine, UKZN 4 Grey’s Hospital, Department of Neurology, UKZN HIV associated neurocognitive disorder in a peri-urban HIV clinic in KwaZulu-Natal, South Africa

Background Aims and methods Prevalence: 15-60% but is unknown in KwaZulu-Natal Neurocognitive tests: tedious, specialized personnel Aims and methods Prevalence of HAND using International HIV Dementia Scale Functional capacity of those with HAND using Eastern Cooperative Oncology Group Factors associated with HAND Investigate the utility of two other neurocognitive tests Determine association between HAND and non-adherence Consecutive HIV infected, ART naïve patients were enrolled Exclusion: Age > 65, CNS infection/disease, mental health care users Nightingale et al, Lancet Neuro, 2014

Results 146 patients Prevalence: 53% Female (54.1%) African (99.3%) Age: median 35 years old (range 18-58 years old) CD4 count: median 178 cells/uL (IQR 86 – 283.5 cells/uL) Prevalence: 53% No functional impairment in 99.9% using ECOG# Risk factors: Age > 50 years old (p=0.003), CD4 count not associated with HAND GUGT* and CESD-r** did not correlate with IHDS Detectable viral load after 6 months ART ≈ non-adherence. HAND 35% and no HAND 20% (p = 0.06) *(GUGT)Get-up-and-go Test **(CESD-R)Centers for Epidemiological Study – Depression scale -revised # (ECOG) Eastern Cooperative Oncology Group

Conclusion High prevalence of HAND in this setting Asymptomatic neurocognitive impairment: predominant presentation of HAND Leads to symptomatic forms of HAND Risk factors: Age > 50 years old Routine screening of older patients recommended HAND and non-adherence association requires further exploration

Acknowledgements Co-investigators Funder: Mentorship grant from Canadian Prevention and Treatment Network Medical and nursing staff at Edendale CDC Clinic for their assistance Ms Zama Mhlongo, research assistant