Frequency of and risk factors for HIV dementia in an HIV clinic in sub-Saharan Africa

OBJECTIVE: To measure the frequency and associated risk factors of HIV dementia in an HIV clinic in Kampala, Uganda. METHODS: We systematically sampled 78 HIV-seropositive (HIV+) patients from an ambulatory HIV clinic. Participants underwent detailed sociodemographic, medical history, functional, neurologic, and neuropsychological evaluations. One hundred HIV-negative patients were recruited to provide normative data for the neuropsychological tests. A logistic regression model was constructed to determine risk factors associated with the diagnosis of HIV dementia. RESULTS: Thirty-one percent (24 of 78) of the HIV+ patients had HIV dementia. Advanced age and low CD4(+) T-lymphocyte count (CD4 count) were the only variables identified as significant risk factors in the logistic regression model. Each additional 10 years of age conferred a greater than twofold risk of HIV dementia (OR 2.06, 95% CI: 1.05 to 4.07; p < 0.05). Reduced levels of CD4 count (100 cells/muL decrement) was associated with a 60% increase in the odds of having HIV dementia (OR 1.6, 95% CI: 1.04 to 2.33; p < 0.05). CONCLUSION: HIV dementia is common in HIV-seropositive Ugandan individuals attending an AIDS clinic. It is more frequently associated with patients of advanced age and decreased CD4 count.