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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
HIV subtype D is associated with dementia, compared with subtype A, in immunosuppressed individuals at risk of cognitive impairment in Kampala, Uganda
Clinical Infectious Diseases, Volume 49, No. 5, Year 2009
Notification
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Description
Background. In the United States, clade B is the predominant human immunodeficiency virus (HIV) subtype, whereas in sub-Saharan Africa, clades A, C, and D are the predominant subtypes. HIV subtype may have an impact on HIV disease progression. The effect of HIV subtype on the risk of dementia has, to our knowledge, not been examined. The objective of this study was to examine the relationship between HIV subtype and the severity of HIV-associated cognitive impairment among individuals initiating antiretroviral therapy in Uganda. Methods. Sixty antiretroviral-naive HIV-infected individuals with advanced immunosuppression who were at risk of HIV-associated cognitive impairment underwent neurological, neuropsychological, and functional assessments, and gag and gp41 regions were subtyped. Subtype assignments were generated by sequence analysis using a portion of the gag and gp41 regions. Results. Thirty-three HIV-infected individuals were infected with subtype A, 2 with subtype C, 9 with subtype D, and 16 with A/D recombinants. Eight (89%) of 9 HIV-infected individuals with subtype D had dementia, compared with 7 (24%) of 33 HIV-infected individuals with subtype A (P = .004). Conclusions. These results suggest that, in untreated HIV-infected individuals with advanced immunosuppression who are at risk of developing HIV-associated cognitive impairment, HIV dementia maybe more common among patients infected with subtype D virus than among those infected with subtype A virus. These findings provide the first evidence, to our knowledge, to demonstrate that HIV subtypes may have a pathogenetic factor with respect to their capacity to cause cognitive impairment. Additional studies are needed to confirm this observation and to define the mechanism by which subtype D leads to an increased risk of neuropathogenesis. © 2009 by the Infectious Diseases Society of America. All rights reserved.
Authors & Co-Authors
Sacktor, Ned Charlton
United States, Baltimore
Johns Hopkins University
United States, Baltimore
Johns Hopkins Bayview Medical Center
Nakasujja, Noeline
Uganda, Kampala
Makerere University
Skolasky, Richard Leroy
United States, Baltimore
Johns Hopkins University
Rezapour, Mona
United States, Bethesda
National Institute of Allergy and Infectious Diseases Niaid
Robertson, Kevin R.
United States, Chapel Hill
The University of North Carolina at Chapel Hill
Musisi, Seggane M.
Uganda, Kampala
Makerere University
Katabira, Elly Tebasoboke
Uganda, Kampala
Makerere University
Ronald, Allan R.
Canada, Winnipeg
University of Manitoba
Clifford, David B.
United States, St. Louis
Washington University in St. Louis
Laeyendecker, Oliver B.
United States, Baltimore
Johns Hopkins University
United States, Bethesda
National Institute of Allergy and Infectious Diseases Niaid
Quinn, Thomas Charles
United States, Baltimore
Johns Hopkins University
United States, Bethesda
National Institute of Allergy and Infectious Diseases Niaid
Statistics
Citations: 135
Authors: 11
Affiliations: 7
Identifiers
Doi:
10.1086/605284
ISSN:
10584838
Research Areas
Infectious Diseases
Mental Health
Study Locations
Uganda