Abstract #273  -  HIV-associated neurocognitive disorders in Botswana: a pilot study
Authors:   Presenting Author:   Ms Kealeboga Jeremiah - Botswana-UPenn
Additional Authors:  Dr  Andrew  Steenhoff, Dr Mosepele Mosepele, Dr Catherine Cherry, Dr Katherine Lawler,
Aim: This preliminary study explored the use of the cognitive tests to detect possible impairment in HIV-positive (HIV+) individuals in Botswana. The goals of this study were to: (1) develop practical, useful measures of cognition for use with HIV+ patients in Botswana; (2) determine if testing methods used in Western countries are appropriate for use in Botswana; (3) determine the effect of depression/anxiety on tests of cognitive function.
Method / Issue: This was a cross-sectional study of 60 HIV+ individuals randomly selected for participation from an outpatient HIV clinic in Gaborone, Botswana. 60 HIV- control subjects were matched for age, education, and gender. A verbal learning test (Botswana Auditory Verbal Learning Test) was developed to be culturally appropriate for use in Botswana. Other cognitive domains tested included processing speed, executive functioning, and fine motor speed. All tests were translated into Setswana and back-translated. Patients and control subjects received a detailed clinical history, neuropsychological testing, and assessment of depression/anxiety, daily activities, and alcohol use.
Results / Comments: This study demonstrated the utility of tests of cognitive function and emotion/affect to assess HIV+ individuals in Botswana. We describe the specific pattern of neuropsychological deficits associated with HIV, referred to as HIV-associated neurocognitive disorders (HAND), which has been attributed to damage to the fronto-striatial circuitry of the brain.
Discussion: A relatively brief battery of neuropsychological tests may be useful in diagnosing cognitive impairment in HIV+ individuals in resource-limited regions, but will require local demographically adjusted normative data.
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