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HIV-Associated Dementia Linked to Disease Subtype

Study among Ugandan patients finds dementia more common with subtype D HIV infection

FRIDAY, Sept. 4 (HealthDay News) -- HIV-associated cognitive impairment may be more common in persons who are infected with the HIV subtype D, according to a study in the Sept. 1 issue of Clinical Infectious Diseases.

Ned Sacktor, M.D., of Johns Hopkins University School of Medicine in Baltimore, and colleagues conducted neurological, neuropsychological, and functional assessments of 60 HIV-infected subjects in Kampala, Uganda, who were at risk for HIV-associated cognitive impairment and had not begun antiretroviral therapy. The researchers assigned subtypes through sequence analysis using a portion of the gag and gp41 regions and assessed the association of HIV subtype to severity of HIV-associated cognitive impairment.

The researchers found that 33 of the subjects had subtype A HIV infection, nine had subtype D infection, two had subtype C infection, and 16 were infected with A/D recombinants. Eight (89 percent) of the subjects with subtype D infection had dementia, compared with seven (24 percent) of the 33 subjects with subtype A infection.

"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," the authors conclude. "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."

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