Relationship between HIV stage in adults and psychomotor speed neurocognitive score at initiation of care at Kangundo sub-county hospital

Abstract

Background: Human Immunodeficiency Virus (HIV) and acquired immunodeficiency syndrome (AIDS) is associated with cognitive impairment which affects psychomotor speed. Psychomotor slowing is a predictor of dementia and death in people living with HIV and AIDS. The purpose of this study is to assess the relationship between HIV disease stage and psychomotor speed neurocognitive score which will add to the body of knowledge required to manage patients with HIVand AIDS. Objective: To determine the relationship between psychomotor speed neurocognitive score and the HIV disease stage in adults at initiation of care Study design and methods: This was a cross sectional study which was conducted at Kangundo sub-county hospital comprehensive care centre. All newly initiated into care HIV seropositive patients aged 18-50 years were studied. A pretested questionnaire was used to collect data from participants. The grooved pegboard test was used to award psychomotor speed neurocognitive scores. Participants were classified into world health organization stage I to IV. Blood samples were obtained for the measurement of cluster of differentiation 4 cell (CD4) counts. Descriptive statistics were used to summarize data. Mann Whitney U test, spearman‘s rho and multiple linear regression were employed in the analysis. Z scores were used to determine those with abnormal scores. All analysis was done in statistical package for social sciences. P value <0.05 was considered significant. Results: A total of 72 patients participated in the study, mean age was 35.5(±7.6) and 36(±8.3) for asymptomatic and symptomatic groups respectively. The median CD4 count was 434(216, 561) and 76(27.25, 296) for asymptomatic and symptomatic groups respectively. The WHO stage did not have a significant effect on the psychomotor speed neurocognitive score (p=>0.05). The CD4 count had a significant effect on psychomotor speed neurocognitive score (p=0.001) Conclusions: The WHO stage did not have a significant effect on psychomotor speed neurocognitive score. There was a significant correlation between CD4 counts and psychomotor speed neurocognitive score. Recommendations Efforts should be made to ensure that the CD4 counts of people living with HIVand AIDS do not continue to fall after initiation into care in order to preserve psychomotor function. Limitations The study did not exclude patients suffering from diabetes and hypertension which may act as confounding factors. Brain imaging studies were not done to rule out any other brain pathology