[MoAb0302] Neurocognitive impairment, symptomatic peripheral neuropathy and depression are highly prevalent in HIV infected outpatients within the Asia Pacific region: findings of the Asia Pacific NeuroAIDS consortium (APNAC) study

16th International AIDS Conference

Toronto, Canada - August 13 - 18, 2006

NEUROCOGNITIVE IMPAIRMENT, SYMPTOMATIC PERIPHERAL NEUROPATHY AND DEPRESSION ARE HIGHLY PREVALENT IN HIV INFECTED OUTPATIENTS WITHIN THE ASIA PACIFIC REGION: FINDINGS OF THE ASIA PACIFIC NeuroAIDS CONSORTIUM (APNAC) STUDY

Int Conf AIDS. 2006 Aug 13-18;16 Abstract No. MoAb0302

Wright E.¹, Brew B.², Kongsaengdao S.³, Arayawithchanont A.⁴, Samintarapunya K.⁵, Imran D.⁶, Lun W.⁷, Kamarulzaman A.⁸, Li P.⁹, Tau G.¹⁰, Vonthanak S.¹¹, Sarim C.¹¹, Huffam S.¹¹, Kishore K.¹², Ali S.T.¹³, Robertson K.¹⁴, Lal L.¹⁵, Lim M.¹⁵, Devadson D.¹⁵, Bain P.², Dwyer R.¹⁶, McCormack G.¹, Scholten C.¹, Cherry C.¹⁵, McArthur J.¹⁷, Wesselingh S.¹⁵
¹The Alfred Hospital, Melbourne, Australia, ²St Vincent's Hospital, Sydney, Australia, ³Rajavithi Hospital, Bangkok, Thailand, ⁴Sappasithiprasong Hospital, Ubon Ratchathani, Thailand, ⁵Lampang Hospital, Lampang, Thailand, ⁶Cipto Mangunkusomo Hospital, Jakarta, Indonesia, ⁷Ditan Hospital, Beijing, China, ⁸University of Malaya Medical Centre, Kuala Lumpur, Malaysia, ⁹Queen Elizabeth Hospital, Hong Kong, Hong Kong, ¹⁰Port Moresby Hospital, Port Moresby, Papua New Guinea, ¹¹National Centre HIV/AIDS, Dermatology and STD, Phnom Penh, Cambodia, ¹²Fiji School Medicine, Suva, Fiji, ¹³Ministry of Health, Suva, Fiji, ¹⁴University of North Carolina at Chapel Hill, Chapel Hill, United States, ¹⁵Burnet Institute, Melbourne, Australia, ¹⁶Monash University, Melbourne, Australia, ¹⁷Johns Hopkins School Medicine, Baltimore, United States

BACKGROUND: The prevalence of HIV-related neurocognitive impairment (NCI) in the AP region is unknown. HIV dementia and symptomatic peripheral neuropathy (PN) are reportedly uncommon. APNAC undertook a cross-sectional study in 8 countries of the region to determine prevalence of NCI and PN. Study hypothesis: NCI and PN are prevalent but under-diagnosed. Results from sites in Thailand, Indonesia, China and Malaysia are presented.

METHODS: HIV positive outpatients were screened for NCI, PN and depression. The neurocognitive test battery comprised grooved pegboard, finger tapper, timed gait and category fluency. NCI definition: normal: all tests ≥1SD; equivocal: ≤1SD on 1 test; mild-moderate: ≤1SD on 2 tests, or ≤2SD on 1 test, up to –4SD total; severe: ≥4SD. Results were analysed using US and APNAC site control norms. The ACTG PN screening tool was used. Definite PN: symptoms + vibration at great toes <10 seconds + absent ankle reflexes; probable PN (pPN): symptoms + one of remaining 2 criteria. CES-D 20 was used for depression screening. Student t-tests and tests for comparison of proportions were used.

RESULTS: 504 outpatients were enrolled and 220 evaluated: median age 33 years; male 73%; median CD4 cell count 177/mL; prior AIDS 61%; 148/220 patients (67%) were receiving HAART with 37% receiving didanosine, stavudine, or both. Mild-moderate and severe NCI were found in 24% and 64% patients, respectively. PN and pPN were found in 6.3% and 52% patients, respectively. 32% of patients reached the CES-D cutoff. Patients with severe NCI were older and had lower nadir CD4 counts than those without NCI (p<0.05). Patients with pPN were significantly likelier to have used dideoxynucleosides than those without PN (p<0.05). <5% of patients received pain relief or antidepressants.

CONCLUSIONS: HIV-related NCI, symptomatic PN and depression are common under-diagnosed conditions in HIV-infected outpatients at sites in Thailand, Indonesia, China and Malaysia and require further study

Download PDF of this abstract.

Download Power Point Presentation.

2006-08-13
MoAb0302

Copyright © 2006 - International AIDS Society (IAS). All information and content relating to the abstracts from the 16th International AIDS Conference, such as text, graphics, logos, button icons, images, audio clips, and software is protected by copyright. Permission is hereby granted for the non-commercial use or reproduction of the information on this web site, provided that the use of such information is accompanied by an acknowledgement that IAS is the source of the information and the name of the author of the article.

AEGiS is a 501c(3) not-for-profit organization made possible through unrestricted funding from Boehringer Ingelheim, Bridgestone/Firestone Charitable Trust, Bristol-Myers Squibb Company, Elton John AIDS Foundation, GlaxoSmithKline, the National Library of Medicine, Roche / Trimeris, and donations from users like you. Always watch for outdated information. This article first appeared in 2006. This material is designed to support, not replace, the relationship that exists between you and your doctor.

AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.

Copyright ©1980, 2006. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content. Permission is hereby granted for the non-commercial use or reproduction of the information herein, provided that the use of such information is accompanied by an acknowledgement that IAS is the source of the information and the name of the author of the article.