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2011 ; 17
(2
): 166-75
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Neurologic manifestations of human immunodeficiency virus-2: dementia,
myelopathy, and neuropathy in West Africa
#MMPMID21424866
Choi Y
; Townend J
; Vincent T
; Zaidi I
; Sarge-Njie R
; Jaye A
; Clifford DB
J Neurovirol
2011[Apr]; 17
(2
): 166-75
PMID21424866
show ga
While well documented in human immunodeficiency virus (HIV)-1, neurologic
sequelae have not been systematically evaluated in HIV-2. After excluding for
confounding comorbidities, 67 individuals from a rural cohort in Guinea-Bissau
(22 HIV-2 participants, 45 seronegative controls) were evaluated.
HIV?+?individuals were divided into CD4?350 and CD4???350 for analysis.
HIV-associated neurocognitive disorders (HAND), assessed by the International HIV
Dementia Scale (IHDS), distal sensory polyneuropathy (DSPN), and myelopathy were
the main outcome variables. In univariate analysis, there was no difference in
IHDS scores among groups. When analyzed by primary education attainment, IHDS
scores were nonsignificantly higher (p?=?0.06) with more education. There was no
significant difference in DSPN prevalence among groups; overall, 45% of
participants had DSPN. There were no cases of myelopathy. In multivariate linear
regression, higher IHDS scores were significantly correlated with older age
(coefficient?=?-0.11, p?0.001). Logistic regression analysis showed that older
age (odds ratio (OR) 95% CI 1.04-1.20), lower CD4 count (OR 95% CI 0.996-0.999),
and higher BMI (OR 95% CI 1.02-1.43) significantly predicted the presence of
DSPN. While a significant increase in cognitive impairment was not observed in
HIV-2-infected individuals, the study suggests the IHDS may be a less effective
screening tool for HAND in settings of lower educational attainment as
encountered in rural Guinea-Bissau. Similar to HIV-1, DSPN seems to occur with
lower CD4 counts in HIV-2. Further study of the viral-host interactions in HIV-2
and its consequent neurological diseases may provide an avenue for understanding
the epidemic problems of HIV-1.