EMBARGOED FOR RELEASE UNTIL 2 PM ET, April 28, 2004
Dementia, Sensory Neuropathy in Sub-Saharan HIV-Positive Patients
Updated with new data
San Francisco – Dementia and sensory neuropathy are common among HIV-positive individuals in sub-Saharan Africa, according to research that will be presented at the American Academy of Neurology 56th Annual Meeting in San Francisco, Calif., April 24 – May 1, 2004. “Two thirds of all HIV-positive individuals—some 26.6 million individuals—live in the countries of sub-Saharan Africa,” said lead study author Matthew Wong of McMaster University in Ontario. “Despite these large numbers, the frequency of neurological complications of HIV infection in this population is largely unknown.” In the United States, dementia is seen in 10-15 percent of AIDS patients, and sensory neuropathy in 30 percent. To determine the corresponding rates in sub-Saharan African populations, Wong and colleagues performed detailed demographic, neurological, neuropsychological, and functional assessments on 81 HIV-positive and 76 HIV-negative individuals at the Academic Alliance Infectious Disease Clinic in Kampala, Uganda. Dementia was present in 30 percent of all HIV-positive patients. Within the subgroup whose CD4 counts were below 200, dementia was present in 33 percent. A CD4 count below 200 is a standard threshold for initiating anti-retroviral therapy. Thirty-seven percent of patients complained of numbness, tingling or pain from sensory neuropathy, and neurological signs of sensory neuropathy were seen in 46 percent. HIV-positive patients were also approximately 25 percent more functionally impaired than HIV-negative patients, and showed decreased abilities on tests of verbal recall, psychomotor speed, and motor performance. “HIV-positive individuals with advanced infection have impaired verbal memory, motor, and functional performance compared to HIV-negative individuals,” said Wong. He also suggested that the International HIV Dementia Scale, used in this study, may be a useful rapid screening test for HIV dementia in the developing world, since it can be performed quickly by non-neurologists without special equipment. Wong also emphasized the importance of governments, non-governmental organizations and the pharmaceutical industry working together to improve access to anti-retrovirals for HIV-positive patients in Africa. “We know in North America that anti-retroviral medications not only prolong an individual’s life, but in the case of HIV dementia have been shown in a substantial proportion of cases to improve the condition, or at least halt its progression. There should be no reason that this would not hold true in Africa.”
The American Academy of Neurology is the world's largest association of neurologists and neuroscience professionals, with 32,000 members. The AAN is dedicated to promoting the highest quality patient-centered neurologic care. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as Alzheimer's disease, stroke, migraine, multiple sclerosis, concussion, Parkinson's disease and epilepsy.
Editor's Notes:Dr. Wong will present this research during the 56th Annual Meeting at 1:45 p.m. PT on Thursday, April 29 in Room 310 of the Moscone Convention Center. He will be available for media questions during a briefing at 11:00 a.m. PT, Wednesday, April 28, in the on-site Press Interview Room, Room 214.