The Veterans Aging Cohort Study Index is not associated with HIV-associated neurocognitive disorders in Uganda
The Veterans Aging Cohort Study (VACS) Index has been associated with HIV-associated neurocognitive disorder (HAND) in some populations but has not been studied in sub-Saharan Africa. We investigated whether the VACS Index is associated with HAND in a rural population in Rakai, Uganda. HIV-infected (HIV+) adults on antiretroviral therapy underwent a neurocognitive battery for determination of HAND stage using Frascati criteria. VACS component scores were recorded for all participants. Out of 156 study participants, HAND stages were 49% normal cognition, 15% asymptomatic neurocognitive impairment, 31% minor neurocognitive disorder, and 7% HIV-associated dementia. There was no significant association between VACS Index and any HAND stage. In this first study of the VACS Index in sub-Saharan Africa, we found no association between VACS Index score and HAND.
KeywordsHIV-associated neurocognitive disorder Veterans aging cohort study index Uganda HIV Global health
This study was supported by the National Institutes of Health (MH099733, MH075673, MH080661-08, L30NS088658, NS065729-05S2, P30AI094189-01A1) and the Johns Hopkins Center for Global Health.
Compliance with ethical standards
Written informed consent was obtained from all study participants. This study was approved by the Western Institutional Review Board, the Uganda Virus Research Institute Research and Ethics Committee, and the Uganda National Council for Science and Technology.
Conflict of interest
The authors declare that they have no conflicts of interest.
- Hammer SM, Squires KE, Hughes MD, Grimes JM, Demeter LM, Currier JS et al (2002) A controlled trial of two nucleoside analogues plus Indinavir in persons with human immunodeficiency virus infection and CD4 cell counts of 200 per cubic millimeter or less. N Engl J Med. https://doi.org/10.1056/nejm199709113371101 CrossRefGoogle Scholar
- Hudson M, Sheron N, Rowe IA, Hirschfield GM (2017) Should we screen for cirrhosis? BMJ (Online). https://doi.org/10.1136/bmj.j3233
- Justice AC, Freiberg MS, Tracy R, Kuller L, Tate JP, Goetz MB et al (2012) Does an index composed of clinical data reflect effects of inflammation, coagulation, and monocyte activation on mortality among those aging with HIV? Clin Infect Dis. https://doi.org/10.1093/cid/cir989 CrossRefGoogle Scholar
- Kwasa J, Cettomai D, Lwanya E, Osiemo D, Oyaro P, Birbeck GL et al (2012) Lessons learned developing a diagnostic tool for HIV-associated dementia feasible to implement in resource-limited settings: pilot testing in Kenya. PLoS One. https://doi.org/10.1371/journal.pone.0032898 CrossRefGoogle Scholar
- Marquine MJ, Sakamoto M, Dufour C, Rooney A, Fazeli P, Umlauf A et al (2016) The impact of ethnicity/race on the association between the Veterans Aging Cohort Study (VACS) Index and neurocognitive function among HIV-infected persons. J NeuroVirology. https://doi.org/10.1007/s13365-015-0411-6 CrossRefGoogle Scholar
- Rourke, SB (2015) Asymptomatic neurocognitive impairment (ANI) is associated with progression to symptomatic HIV-associated neurocognitive disorders (HAND) in people with HIV: results from the Ontario HIV treatment network (OHTN) cohort study. Canadian Journal of Infectious Diseases and Medical MicrobiologyGoogle Scholar
- Sacktor, N., Saylor, D., Nakigozi, G., Nakasujja, N., Robertson, K., Grabowski, M. K., … Wawer, M. J. (2019). Effect of HIV subtype and antiretroviral therapy on HIV-associated neurocognitive disorder stage in Rakai, Uganda. JAIDS Journal of Acquired Immune Deficiency Syndromes https://doi.org/10.1097/qai.0000000000001992 CrossRefGoogle Scholar
- Shah, A., Lydecker, A., & Murray, K. (2009). Use of the FIB4 index for non invasive evaluation of fibrosis in non alcoholic fatty liver disease. … and Hepatology: The …. https://doi.org/10.1016/j.cgh.2009.05.033.USE