1. Abstract no. WEPDB0104
JC Mogambery1, H Dawood2, D Wilson3, A Moodley4
1 Grey’s Hospital, Infectious Disease Unit, UKZN
2 Grey’s Hospital, Infectious Disease Unit, UKZN, CAPRISA
3 Edendale Hospital, Department of Internal Medicine, UKZN
4 Grey’s Hospital, Department of Neurology, UKZN
HIV associated neurocognitive disorder in a peri-urban HIV clinic in KwaZulu-Natal, South Africa

2. Background Aims and methods
Prevalence: 15-60% but is unknown in KwaZulu-Natal
Neurocognitive tests: tedious, specialized personnel
Aims and methods
Prevalence of HAND using International HIV Dementia Scale
Functional capacity of those with HAND using Eastern Cooperative Oncology Group
Factors associated with HAND
Investigate the utility of two other neurocognitive tests
Determine association between HAND and non-adherence
Consecutive HIV infected, ART naïve patients were enrolled
Exclusion: Age > 65, CNS infection/disease, mental health care users
Nightingale et al, Lancet Neuro, 2014

3. Results 146 patients Prevalence: 53%
Female (54.1%)
African (99.3%)
Age: median 35 years old (range years old)
CD4 count: median 178 cells/uL (IQR 86 – cells/uL)
Prevalence: 53%
No functional impairment in 99.9% using ECOG#
Risk factors: Age > 50 years old (p=0.003), CD4 count not associated with HAND
GUGT* and CESD-r** did not correlate with IHDS
Detectable viral load after 6 months ART ≈ non-adherence. HAND 35% and no HAND 20% (p = 0.06)
*(GUGT)Get-up-and-go Test
**(CESD-R)Centers for Epidemiological Study – Depression scale -revised
# (ECOG) Eastern Cooperative Oncology Group

4. Conclusion High prevalence of HAND in this setting
Asymptomatic neurocognitive impairment: predominant presentation of HAND
Leads to symptomatic forms of HAND
Risk factors: Age > 50 years old
Routine screening of older patients recommended
HAND and non-adherence association requires further exploration

5. Acknowledgements Co-investigators
Funder: Mentorship grant from Canadian Prevention and Treatment Network
Medical and nursing staff at Edendale CDC Clinic for their assistance
Ms Zama Mhlongo, research assistant