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Memory Performance in HIV/AIDS - A Prospective Case Control Study

Published online by Cambridge University Press:  02 December 2014

Francis E. Odiase ,
Olubunmi A. Ogunrin  and
Adesola A. Ogunniyi
Francis E. Odiase
Affiliation:
Neurology Unit, Department of Medicine, University of Benin Teaching Hospital, Benin City
Olubunmi A. Ogunrin
Affiliation:
Neurology Unit, Department of Medicine, University of Benin Teaching Hospital, Benin City
Adesola A. Ogunniyi
Affiliation:
Neurology Unit, Department of Medicine, University College Hospital, Ibadan, Nigeria
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Abstract

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Background:

Memory impairment, usually impaired retrieval of information, has been described in HIV/AIDS, especially among those with severe illness. Neuro-cognitive disturbances in HIV/AIDS have been linked to poor quality of life and medication adherence. This prospective, case-control study was designed to assess the verbal and non-verbal memory as well as the attention abilities of Nigerian Africans with HIV/AIDS and correlate their performances with their CD4+ T lymphocytes (CD4+) counts.

Methods:

A total of 288 randomly selected subjects, comprising 96 HIV-positive symptomatic patients, 96 HIV-positive asymptomatic patients and 96 HIV-negative controls, participated in the study. The subjects were age-, sex-, and level of education matched. The Recognition Memory Test and Choice Reaction Time tasks, components of the computer-assisted neuropsychological tests battery- the Iron Psychology ‘FePsy’ were used for cognitive assessments.

Results:

The mean memory scores of the HIV-positive asymptomatic subjects did not differ significantly from the controls (p>0.05) but the HIV-positive symptomatic subjects' scores were significantly lower than the controls (p<0.05). Both HIV-positive groups had psychomotor slowing and impaired attention (p<0.05). The HIV-positive subjects with CD4+ counts <200/μl and between 200 and 499/μl had significant memory impairment (p<0.001 and p<0.001 respectively) but there was no significant impairment among those with count ≥500/μl. Impaired ability for sustained attention was however present irrespective of the CD4+ level relative to controls (p<0.001).

Conclusions:

We concluded that there was no significant memory disturbance among HIV-positive asymptomatic subjects despite the presence of impaired attention and psychomotor slowing, and that the severity of immune suppression (as indicated by the CD4+ T lymphocytes count) is a strong determinant of cognitive decline in HIV/AIDS.

Résumé:

RÉSUMÉ:Contexte:

Une atteinte de la mémoire, habituellement de la récupération de l'information, a été décrite chez les patients atteints du VIH/SIDA, spécialement chez ceux dont la maladie est sévère. Les perturbations neuro-cognitives dans le VIH/SIDA ont été associées à une faible qualité de vie et de fidélité à la médication. Cette étude prospective cas-témoin a été conçue dans le but d'évaluer la mémoire verbale et non verbale ainsi que l'attention chez des Africains Nigériens atteints du VIH/SIDA et d'évaluer s'il existe une corrélation avec le décompte des lymphocytes T CD4+ (CD4+).

Méthodes :

288 sujets choisis au hasard, soit 96 patients VIH-positifs symptomatiques, 96 patients VIH-positifs asymptomatiques et 96 témoins VIH-négatifs ont participé à l'étude. Les sujets ont été appariés pour l'âge, le sexe et le niveau de scolarité. L'évaluation cognitive a été effectuée au moyen du Recognition Memory Test (RMT) et du Choice Reaction Time Tasks, qui font partie d'une batterie de tests neuropsychologiques informatisés, le Iron Psychology « FePsy ».

Résultats :

Les scores mnésiques moyens des sujets asymptomatiques VIH-positifs n'étaient pas significativement différents de ceux des témoins (p > 0,05). Cependant, les scores des sujets VIH-positifs symptomatiques étaient significativement plus bas que ceux des témoins (p < 0,05). Les deux groupes de patients VIH-positifs avaient un ralentissement psychomoteur et un déficit d'attention (p < 0,05). Les sujets VIH-positifs dont le décompte CD4+ était inférieur à 200/Ì et entre 200 et 499/Ì avaient une atteinte mnésique significative (p < 0,001 et p < 0,001 respectivement). Il n'existait pas d'atteinte significative chez ceux dont le décompte était ? 500/Ì. Cependant, ils avaient un déficit de l'attention soutenue par rapport aux témoins (p < 0,001), quel que soit leur décompte CD4+.

Conclusions :

Il n'y a pas de perturbation significative de la mémoire chez les sujets VIH-positifs asymptomatiques, malgré la présence d'un déficit de l'attention et d'un ralentissement psychomoteur. La sévérité de la suppression immunitaire (basée sur le décompte des lymphocytes T CD4+) est un déterminant puissant du déclin cognitif chez les sujets atteints du VIH/SIDA.

Type
Original Articles
Information
Canadian Journal of Neurological Sciences , Volume 34 , Issue 2 , May 2007 , pp. 154 - 159
Copyright
Copyright © The Canadian Journal of Neurological 2007

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