31 January 2007
HIV Dementia Skyrockets In Africa
by George Atkinson

A study by Johns Hopkins researchers, published in Neurology, suggests that the rate of HIV-associated dementia is so high in sub-Saharan Africa that HIV dementia (along with Alzheimer's disease and dementia from strokes) may be among the most common forms of dementia in the world.

HIV-associated dementia is defined as memory, learning, behavioral and motor disabilities that interfere with normal daily life and in extreme cases lead to total disability. Unlike Alzheimer's disease and stroke-induced dementia, HIV dementia is treatable and potentially reversible with the same antiretroviral medication that is used to treat the infection. Sometimes, treatment can even completely restore normal cognitive function to those affected.

Lead researcher, Ned Sacktor, examined HIV-positive subjects in Kampala, Uganda, and conducted a series of comprehensive neurological and neuropsychological tests and functional assessments. He found that nearly one-third (31 percent) exhibited signs of HIV dementia. "Clearly, large-scale testing would have to be conducted before we know the global reach of HIV dementia, but this study sends a clear message that it exists in high proportions in sub-Saharan Africa and is an under-recognized condition that needs to be studied and treated," Sacktor said. "If the rate we saw in our study translates across sub-Saharan Africa, we're looking at more than 8,000,000 people in this region with HIV dementia," he added.

HIV dementia in poor regions of the world adds enormously to the social and economic burden of their populations and governments. Dementia not only disrupts jobs and adds to the cost of care, but also interferes with a patient's ability to adhere to a regular course of antiretroviral medication, thus increasing the risk of drug resistance. People with dementia also are less likely to practice safe sex.

"We hope studies like these will shed additional light on the devastating problem of HIV in resource-limited countries like Uganda and encourage more programs that bring much-needed medication to these poor regions of the world," Sacktor concluded.

Based on material from Johns Hopkins Medical Institutions

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