{"title":"非洲艾滋病毒相关神经认知障碍:挑战、特点和未来方向。","authors":"Tobi Olajide, Evelyn Ogungbemi, Gideon Olajide, Deborah Ogundijo, Oluwanifemi Osakuade, Favour Moshood","doi":"10.1186/s12981-024-00677-6","DOIUrl":null,"url":null,"abstract":"<p><p>The impact of Human Immunodeficiency Virus (HIV) on neurocognition in Africa is a pressing public health issue, with profound implications for both individual well-being and healthcare systems across the continent. This narrative review aims to elucidate the intricate relationship between HIV infection and neurocognitive function, particularly focusing on HIV-associated neurocognitive disorders (HAND), the effects of antiretroviral therapy (ART), and neuropathological changes. Evidence from Africa emphasizes the variability in the prevalence of neurocognitive impairment among people living with HIV. For instance, a meta-analysis showed that Central and South Africa had the highest pooled prevalence of neurocognitive impairment (NCI) (49.33%), followed by East Africa (45.04%) and West Africa (42.40%). These differences may reflect varying ART coverage, healthcare infrastructure, and the prevalence of co-infections like tuberculosis highlighting the importance of region-specific interventions and support services tailored to local contexts. Furthermore, challenges such as late diagnosis, methodological variations, treatment non-adherence, and limited access to specialized care exacerbate the burden of neurocognitive impairment in this setting. Addressing the complex intersection of HIV and neurocognition in Africa requires a multifaceted approach involving various stakeholders, including healthcare providers, policymakers, researchers, and community organizations. Enhancing awareness, education, and capacity- building initiatives can improve early detection and management of neurocognitive disorders among individuals living with HIV. Moreover, investment in infrastructure and resources for neurocognitive care, including diagnostic tools and rehabilitation services, is essential to meet the growing needs of this population. Additionally, promoting research collaboration and knowledge exchange is important for advancing our understanding of HIV-related neurocognitive impairment and developing evidence-based interventions. By fostering partnerships between academia, healthcare institutions, and governmental agencies, we can facilitate the translation of research findings into policy and practice, ultimately improving outcomes and quality of life for individuals affected by HAND in Africa.</p>","PeriodicalId":7503,"journal":{"name":"AIDS Research and Therapy","volume":"21 1","pages":"88"},"PeriodicalIF":2.1000,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11605981/pdf/","citationCount":"0","resultStr":"{\"title\":\"HIV-associated neurocognitive disorders in Africa: challenges, peculiarities, and future directions.\",\"authors\":\"Tobi Olajide, Evelyn Ogungbemi, Gideon Olajide, Deborah Ogundijo, Oluwanifemi Osakuade, Favour Moshood\",\"doi\":\"10.1186/s12981-024-00677-6\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>The impact of Human Immunodeficiency Virus (HIV) on neurocognition in Africa is a pressing public health issue, with profound implications for both individual well-being and healthcare systems across the continent. This narrative review aims to elucidate the intricate relationship between HIV infection and neurocognitive function, particularly focusing on HIV-associated neurocognitive disorders (HAND), the effects of antiretroviral therapy (ART), and neuropathological changes. Evidence from Africa emphasizes the variability in the prevalence of neurocognitive impairment among people living with HIV. For instance, a meta-analysis showed that Central and South Africa had the highest pooled prevalence of neurocognitive impairment (NCI) (49.33%), followed by East Africa (45.04%) and West Africa (42.40%). These differences may reflect varying ART coverage, healthcare infrastructure, and the prevalence of co-infections like tuberculosis highlighting the importance of region-specific interventions and support services tailored to local contexts. Furthermore, challenges such as late diagnosis, methodological variations, treatment non-adherence, and limited access to specialized care exacerbate the burden of neurocognitive impairment in this setting. Addressing the complex intersection of HIV and neurocognition in Africa requires a multifaceted approach involving various stakeholders, including healthcare providers, policymakers, researchers, and community organizations. Enhancing awareness, education, and capacity- building initiatives can improve early detection and management of neurocognitive disorders among individuals living with HIV. Moreover, investment in infrastructure and resources for neurocognitive care, including diagnostic tools and rehabilitation services, is essential to meet the growing needs of this population. Additionally, promoting research collaboration and knowledge exchange is important for advancing our understanding of HIV-related neurocognitive impairment and developing evidence-based interventions. By fostering partnerships between academia, healthcare institutions, and governmental agencies, we can facilitate the translation of research findings into policy and practice, ultimately improving outcomes and quality of life for individuals affected by HAND in Africa.</p>\",\"PeriodicalId\":7503,\"journal\":{\"name\":\"AIDS Research and Therapy\",\"volume\":\"21 1\",\"pages\":\"88\"},\"PeriodicalIF\":2.1000,\"publicationDate\":\"2024-11-28\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11605981/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"AIDS Research and Therapy\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1186/s12981-024-00677-6\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"INFECTIOUS DISEASES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"AIDS Research and Therapy","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s12981-024-00677-6","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}
HIV-associated neurocognitive disorders in Africa: challenges, peculiarities, and future directions.
The impact of Human Immunodeficiency Virus (HIV) on neurocognition in Africa is a pressing public health issue, with profound implications for both individual well-being and healthcare systems across the continent. This narrative review aims to elucidate the intricate relationship between HIV infection and neurocognitive function, particularly focusing on HIV-associated neurocognitive disorders (HAND), the effects of antiretroviral therapy (ART), and neuropathological changes. Evidence from Africa emphasizes the variability in the prevalence of neurocognitive impairment among people living with HIV. For instance, a meta-analysis showed that Central and South Africa had the highest pooled prevalence of neurocognitive impairment (NCI) (49.33%), followed by East Africa (45.04%) and West Africa (42.40%). These differences may reflect varying ART coverage, healthcare infrastructure, and the prevalence of co-infections like tuberculosis highlighting the importance of region-specific interventions and support services tailored to local contexts. Furthermore, challenges such as late diagnosis, methodological variations, treatment non-adherence, and limited access to specialized care exacerbate the burden of neurocognitive impairment in this setting. Addressing the complex intersection of HIV and neurocognition in Africa requires a multifaceted approach involving various stakeholders, including healthcare providers, policymakers, researchers, and community organizations. Enhancing awareness, education, and capacity- building initiatives can improve early detection and management of neurocognitive disorders among individuals living with HIV. Moreover, investment in infrastructure and resources for neurocognitive care, including diagnostic tools and rehabilitation services, is essential to meet the growing needs of this population. Additionally, promoting research collaboration and knowledge exchange is important for advancing our understanding of HIV-related neurocognitive impairment and developing evidence-based interventions. By fostering partnerships between academia, healthcare institutions, and governmental agencies, we can facilitate the translation of research findings into policy and practice, ultimately improving outcomes and quality of life for individuals affected by HAND in Africa.
期刊介绍:
AIDS Research and Therapy publishes articles on basic science, translational, clinical, social, epidemiological, behavioral and educational sciences articles focused on the treatment and prevention of HIV/AIDS, and the search for the cure. The Journal publishes articles on novel and developing treatment strategies for AIDS as well as on the outcomes of established treatment strategies. Original research articles on animal models that form an essential part of the AIDS treatment research are also considered