Neurobehavioral effects of human immunodeficiency virus infection among former plasma donors in rural China
Robert K Heaton, Lucette A Cysique, Hua Jin, Chuan Shi, Xin Yu, Scott Letendre, Donald R Franklin, Christopher Ake, Ofilio Vigil, J Hampton Atkinson, Thomas D Marcotte, Igor Grant, Zunyou Wu, San Diego HIV Neurobehavioral Research Center Group, Igor Grant, J Hampton Atkinson, Ronald J Ellis, J Allen McCutchan, Thomas D Marcotte, Braden R Hale, Scott Letendre, Edmund Capparelli, Rachel Schrier, Robert K Heaton, Mariana Cherner, Steven Paul Woods, Terry Jernigan, Christine Fennema-Notestine, Sarah L Archibald, John Hesselink, Jacopo Annese, Michael J Taylor, Eliezer Masliah, Ian Everall, Cristian Achim, Douglas Richman, David M Smith, Ian Everall, Stuart Lipton, Rodney von Jaeger, Anthony C Gamst, Clint Cushman, Daniel R Masys, Ian Abramson, Christopher Ake, Florin Vaida, Robert K Heaton, Lucette A Cysique, Hua Jin, Chuan Shi, Xin Yu, Scott Letendre, Donald R Franklin, Christopher Ake, Ofilio Vigil, J Hampton Atkinson, Thomas D Marcotte, Igor Grant, Zunyou Wu, San Diego HIV Neurobehavioral Research Center Group, Igor Grant, J Hampton Atkinson, Ronald J Ellis, J Allen McCutchan, Thomas D Marcotte, Braden R Hale, Scott Letendre, Edmund Capparelli, Rachel Schrier, Robert K Heaton, Mariana Cherner, Steven Paul Woods, Terry Jernigan, Christine Fennema-Notestine, Sarah L Archibald, John Hesselink, Jacopo Annese, Michael J Taylor, Eliezer Masliah, Ian Everall, Cristian Achim, Douglas Richman, David M Smith, Ian Everall, Stuart Lipton, Rodney von Jaeger, Anthony C Gamst, Clint Cushman, Daniel R Masys, Ian Abramson, Christopher Ake, Florin Vaida
Abstract
The human immunodeficiency virus (HIV) epidemic in China has expanded rapidly in recent years, but little is known about the prevalence and features of HIV-associated neurocognitive disorders (HANDs) in this part of the world. We administered a comprehensive Western neuropsychological (NP) test battery to 203 HIV+ and 198 HIV- former plasma donors in the rural area of Anhui province. They found that 26% of the HIV- samples, and 46% of the HIV+ samples, were infected with hepatitis C virus (HCV), which can also have central nervous system (CNS) effects. To classify NP impairment, we developed demographically corrected test norms based upon individuals free of both infections (N=141). Using a global summary score, NP impairment was found in 34.2% of the HIV-monoinfected group and 39.7% of the coinfected group, as compared to 12.7% of the uninfected controls (P<.001). HIV+ participants with acquired immunodeficiency syndrome (AIDS) were more likely to be impaired (43%) than non-AIDS individuals (29%; P<.05). Lastly, when all infection groups were combined, participants with NP impairment reported more cognitive complaints (P<.01) and increased dependence in everyday functioning (P=.01). In sum, NP impairment in this large rural Chinese sample was associated with both HIV and HCV infections, and the impairment's prevalence, severity, and pattern were similar to those reported by Western studies. Clinical significance of NP impairment in this population is suggested by the participants' reports of reduced everyday functioning. These findings indicate that HAND is likely to be an important feature of HIV infection in developing countries, underscoring the need for international efforts to develop CNS-relevant treatments.
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Source: PubMed