Journal of NeuroVirology

, Volume 12, Issue 5, pp 356–364

Prevalence of human immunodeficiency virus-associated cognitive impairment in a group of Hispanic women at risk for neurological impairment

  • Valerie Wojna
  • Richard L. Skolasky
  • Rosa Hechavarría
  • Raúl Mayo
  • Ola Selnes
  • Justin C. McArthur
  • Loyda M. Meléndez
  • Elizabeth Maldonado
  • Carmen D. Zorrilla
  • Hermes García
  • Edmundo Kraiselburd
  • Avindra Nath
Article

DOI: 10.1080/13550280600964576

Cite this article as:
Wojna, V., Skolasky, R.L., Hechavarría, R. et al. Journal of NeuroVirology (2006) 12: 356. doi:10.1080/13550280600964576

Abstract

Human immunodeficiency virus (HIV)-associated cognitive impairment, a significant cause of morbidity, affects up to 30% of HIV-infected people. Its prevalence doubled as patients began to live longer after the introduction of highly active retroviral therapy. Women are now one of the fastest growing groups with acquired immunodeficiency syndrome (AIDS) in the United States and Puerto Rico, but relatively little is known about the prevalence and characteristics of cognitive dysfunction in HIV-infected women. In this study the authors investigated its prevalence in a group of HIV-1—seropositive Hispanic women in Puerto Rico. Forty-nine women with a nadir CD4 cell count of ≤500 cells/mm3 were enrolled. Cognitive impairment was defined according to the American Academy of Neurology criteria for HIV dementia as modified to identify an “asymptomatic cognitively impaired” group. Observed prevalence was compared with prevalence in other populations in United States, Europe, and Australia. Differences in clinical markers and neuropsychological test performance among the cohort stratified by cognitive impairment were tested. Cognitive impairment was observed in 77.6% (38/49) of cases; asymptomatic cognitive impairment in 32.7% (16/49); minor cognitive motor disorders in 16.3% (8/49); and HIV-associated dementia (HAD) in 28.6% (14/49). Cognitive impairment did not correlate with age, CD4 cell count, viral load, or treatment modality. The cross-sectional prevalence of HIV-associated cognitive impairment was 77.6% (28.6% for HAD). These findings should enhance awareness of the prevalence of HIV-associated cognitive impairment, both clinically apparent and “asymptomatic,” in Hispanic women and lead to improvements in areas such as education and compliance and to reevaluation of treatment interventions.

Keywords

cognitive impairment Hispanics HIV prevalence women 
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Copyright information

© Journal of NeuroVirology, Inc. 2006

Authors and Affiliations

  • Valerie Wojna
    • 1
    • 2
  • Richard L. Skolasky
    • 3
  • Rosa Hechavarría
    • 1
    • 4
  • Raúl Mayo
    • 1
    • 4
  • Ola Selnes
    • 5
  • Justin C. McArthur
    • 5
  • Loyda M. Meléndez
    • 1
    • 6
  • Elizabeth Maldonado
    • 1
  • Carmen D. Zorrilla
    • 7
  • Hermes García
    • 8
  • Edmundo Kraiselburd
    • 1
    • 9
  • Avindra Nath
    • 5
  1. 1.NeuroAIDS SNRPUniversity of Puerto Rico Medical Sciences CampusSan JuanPR
  2. 2.Neurology Section of the Department of Internal MedicineUniversity of Puerto Rico Medical Sciences CampusSan JuanPuerto Rico
  3. 3.Department of Orthopaedic SurgeryThe Johns Hopkins UniversityBaltimoreUSA
  4. 4.Department of Physical Medicine, Rehabilitation, and Sport MedicineUniversity of Puerto Rico Medical Sciences CampusSan JuanPuerto Rico
  5. 5.Department of NeurologyThe Johns Hopkins UniversityBaltimoreUSA
  6. 6.Department of MicrobiologyUniversity of Puerto Rico Medical Sciences CampusSan JuanPuerto Rico
  7. 7.Center of Mother Infant TransmissionUniversity of Puerto RicoSan JuanPuerto Rico
  8. 8.Center of Sexually Transmitted DiseasesPuerto Rico Health DepartmentSan JuanPuerto Rico
  9. 9.Unit of Comparative MedicineUniversity of Puerto Rico Medical Sciences CampusSan JuanPuerto Rico

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