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dc.contributor.authorSacktor, Ned
dc.contributor.authorNakasujja, Noeline
dc.contributor.authorSkolasky, Richard L.
dc.contributor.authorRezapour, Mona
dc.contributor.authorRobertson, Kevin
dc.contributor.authorMusisi, Seggane
dc.contributor.authorKatabira, Elly
dc.contributor.authorRonald, Allan
dc.contributor.authorClifford, David B.
dc.contributor.authorLaeyendecker, Oliver
dc.contributor.authorQuinn, Thomas C.
dc.date.accessioned2013-07-02T11:25:37Z
dc.date.available2013-07-02T11:25:37Z
dc.date.issued2009
dc.identifier.citationSacktor, N et al (2009). HIV Subtype D Is Associated with Dementia, Compared with Subtype A, in Immunosuppressed Individuals at Risk of Cognitive Impairment in Kampala, Uganda, Clinical Infectious Diseases 2009, 49:780–6.en_US
dc.identifier.urihttp://hdl.handle.net/10570/1492
dc.description.abstractBackground. In the United States, clade B is the predominant human immunodeficiency virus (HIV) subtype, whereas in sub-Saharan Africa, clades A, C, and D are the predominant subtypes. HIV subtype may have an impact on HIV disease progression. The effect of HIV subtype on the risk of dementia has, to our knowledge, not been examined. The objective of this study was to examine the relationship between HIV subtype and the severity of HIV-associated cognitive impairment among individuals initiating antiretroviral therapy in Uganda. Methods. Sixty antiretroviral-naive HIV-infected individuals with advanced immunosuppression who were at risk of HIV-associated cognitive impairment underwent neurological, neuropsychological, and functional assessments, and gag and gp41 regions were subtyped. Subtype assignments were generated by sequence analysis using a portion of the gag and gp41 regions. Results. Thirty-three HIV-infected individuals were infected with subtype A, 2 with subtype C, 9 with subtype D, and 16 with A/D recombinants. Eight (89%) of 9 HIV-infected individuals with subtype D had dementia, compared with 7 (24%) of 33 HIV-infected individuals with subtype A (Pp.004). Conclusions. These results suggest that, in untreated HIV-infected individuals with advanced immunosuppression who are at risk of developing HIV-associated cognitive impairment, HIV dementia may be more common among patients infected with subtype D virus than among those infected with subtype A virus. These findings provide the first evidence, to our knowledge, to demonstrate that HIV subtypes may have a pathogenetic factor with respect to their capacity to cause cognitive impairment. Additional studies are needed to confirm this observation and to define the mechanism by which subtype D leads to an increased risk of neuropathogenesis.en_US
dc.description.sponsorshipNeurologic AIDS Research Consortium, National Institute of Mental Health, and Division of Intramural Research of the National Institute of Allergy and Infectious Diseases.en_US
dc.language.isoenen_US
dc.publisherClinical Infectious Diseasesen_US
dc.subjectHIVen_US
dc.subjectDementiaen_US
dc.subjectCognitive imapirementen_US
dc.subjectUgandaen_US
dc.titleHIV Subtype D Is Associated with Dementia, Compared with Subtype A, in Immunosuppressed Individuals at Risk of Cognitive Impairment in Kampala, Ugandaen_US
dc.typeJournal article, peer revieweden_US


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