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HIV subtype is not associated with dementia among individuals with moderate and advanced immunosuppression in Kampala, Uganda

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Abstract

HIV-associated neurocognitive disorders (HAND) are a common neurological manifestation of HIV infection. A previous study suggested that HIV dementia may be more common among patients with subtype D virus than among those with subtype A virus among HIV+ individuals with advanced immunosuppression. We conducted a study to evaluate the frequency of HIV dementia, and the association of HIV dementia with HIV subtype and compartmentalization among HIV+ individuals with moderate and advanced immunosuppression (CD4 lymphocyte count >150 cells/μL and <250 cells/μL). The study enrolled 117 antiretroviral naïve HIV+ individuals in Kampala, Uganda. HIV+ individuals received neurological, neuropsychological testing, and functional assessments, and gag and gp41 regions were subtyped. Subjects were considered infected with a specific subtype if both regions analyzed were from the same subtype. 41 % of the HIV+ individuals had HIV dementia (mean CD4 lymphocyte count = 233 cells/μL). 67 individuals had subtype A, 25 individuals had subtype D, 24 individuals were classified as A/D recombinants, and one individual had subtype C. There was no difference in the frequency of HIV dementia when stratified by HIV subtype A and D and no association with compartmentalization between the cerebrospinal fluid and peripheral blood. These results suggest that HIV dementia is common in HIV+ individuals in Uganda. There was no association between HIV subtype and dementia among HIV+ individuals with moderate and advanced immunosuppression. Future studies should be performed to confirm these results.

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Abbreviations

HIV:

Human immunodeficiency virus

HAND:

HIV-associated neurocognitive disorders

CSF:

Cerebrospinal fluid

AIDS:

Acquired immunodeficiency syndrome

CNS:

Central nervous system

env:

Envelope

ART:

Antiretroviral therapy

ELISA:

Enzyme-linked immunosorbent assay

RNA:

Ribonucleic acid

ANI:

Asymptomatic neurocognitive impairment

MND:

Mild neurocognitive disorder

SD:

Standard deviation

nt:

Nucleotide

CLUSTALW:

Cluster analysis program-W

BIO edit:

Biological sequence alignment editor

PHYLIP:

Phylogeny inference package

GenBank-NIH:

Genetic sequence database bank

gag:

Group specific antigen

gp41:

Glycoprotein 41

NGS:

Next generation sequencing

emPCR:

Emulsion based polymerase chain reaction

DNA:

Deoxyribonucleic acid

ANOVA:

Analysis of variance

μL:

Microliter

CCR-5:

cc-chemokine receptor type 5

CXCR4- C-X-C:

Chemokine receptor type 4

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Funding

This work was supported by the National Institute of Mental Health at the National Institutes of Health (Grant number MH083465). Funding also was provided in part by the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health.

Conflict of interest

The authors have no conflicts of interest to report with the following exception: Dr. Robertson has performed consulting work with ViiV and Abbott.

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Authors and Affiliations

  1. Department of Neurology, Johns Hopkins Bayview Medical Center, 301 Building, Suite 2100, 4940 Eastern Ave., Baltimore, MD, 21224, USA

    Ned Sacktor

  2. Department of Orthopedic Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Richard L. Skolasky

  3. Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Jordyn Manucci, Oliver Laeyendecker & Thomas C. Quinn

  4. Department of Psychiatry, Kampala, Uganda

    Noeline Nakasujja & Seggane Musisi

  5. Department of Medicine, Makerere University, Kampala, Uganda

    Elly Katabira

  6. Laboratory of Immunoregulation, Division of Intramural Research, National Institute of Allergy and Infectious Disease, National Institutes of Health, Bethesda, MD, USA

    Andrew D. Redd, Jordyn Manucci, Oliver Laeyendecker, Sarah K. Wendel & Thomas C. Quinn

  7. Genomics Unit, Research Technologies Branch, Rocky Mountain Laboratories, Division of Intramural Research, NIAID, NIH, Hamilton, MT, USA

    Stephen F Porcella, Craig Martens & Daniel Bruno

  8. Department of Medicine, University of Wisconsin, Madison, WI, USA

    Ozioma C. Okonkwo

  9. Department of Neurology, University of North Carolina, Chapel Hill, NC, USA

    Kevin Robertson

Authors
  1. Ned Sacktor
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  2. Noeline Nakasujja
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  3. Andrew D. Redd
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  4. Jordyn Manucci
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  5. Oliver Laeyendecker
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  6. Sarah K. Wendel
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  7. Stephen F Porcella
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  8. Craig Martens
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  9. Daniel Bruno
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  10. Richard L. Skolasky
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  11. Ozioma C. Okonkwo
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  12. Kevin Robertson
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  13. Seggane Musisi
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  14. Elly Katabira
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  15. Thomas C. Quinn
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Corresponding author

Correspondence to Ned Sacktor.

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Sacktor, N., Nakasujja, N., Redd, A.D. et al. HIV subtype is not associated with dementia among individuals with moderate and advanced immunosuppression in Kampala, Uganda. Metab Brain Dis 29, 261–268 (2014). https://doi.org/10.1007/s11011-014-9498-3

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  • DOI: https://doi.org/10.1007/s11011-014-9498-3

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