Home › Research › Caregiving
Global prevalence and burden of HIV-associated neurocognitive disorder: A meta-analysis
Wang Y, Liu M, Lu Q, Farrell M, Lappin JM, Shi J, Lu L, Bao Y.. Neurology, 2020-09-04
Topic: Risk, prevention and care in population studies
Objective To characterize the prevalence and burden of HIV-associated neurocognitive disorder (HAND) and assess associated factors in the global population with HIV. Methods We searched PubMed and Embase for cross-sectional or cohort studies reporting the prevalence of HAND or its subtypes in HIV-infected adult populations from January 1, 1996, to May 15, 2020, without language restrictions. Two reviewers independently undertook the study selection, data extraction, and quality assessment. We estimated pooled prevalence of HAND by a random effects model and evaluated its overall burden worldwide. Results Of 5,588 records identified, we included 123 studies involving 35,513 participants from 32 countries. The overall prevalence of HAND was 42.6% (95% confidence interval [CI] 39.7-45.5) and did not differ with respect to diagnostic criteria used. The prevalence of asymptomatic neurocognitive impairment, mild neurocognitive disorder, and HIV-associated dementia were 23.5% (20.3-26.8), 13.3% (10.6-16.3), and 5.0% (3.5-6.8) according to the Frascati criteria, respectively. The prevalence of HAND was significantly associated with the level of CD4 nadir, with a prevalence of HAND higher in low CD4 nadir groups (mean/median CD4 nadir Conclusions Our findings suggest that people living with HIV have a high burden of HAND in the antiretroviral therapy (ART) era, especially in sub-Saharan Africa and Latin America. Earlier initiation of ART and sustained adherence to maintain a high-level CD4 cell count and prevent severe immunosuppression is likely to reduce the prevalence and severity of HAND.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Wang, Y., Liu, M., Lu, Q., Farrell, M., Lappin, J. M., Shi, J., et al. (2020). Global prevalence and burden of HIV-associated neurocognitive disorder: A meta-analysis. Neurology. https://doi.org/10.1212/wnl.0000000000010752
Vancouver
Wang Y, Liu M, Lu Q, Farrell M, Lappin JM, Shi J, et al. Global prevalence and burden of HIV-associated neurocognitive disorder: A meta-analysis. Neurology. 2020. doi:10.1212/wnl.0000000000010752. PMID: 32887786.
BibTeX
@article{wang2020-32887786,
author = {Wang, Y. and Liu, M. and Lu, Q. and Farrell, M. and Lappin, J. M. and Shi, J. and Lu, L. and Bao, Y.},
title = {{Global prevalence and burden of HIV-associated neurocognitive disorder: A meta-analysis}},
journal = {Neurology},
year = {2020},
doi = {10.1212/wnl.0000000000010752},
pmid = {32887786},
url = {https://doi.org/10.1212/wnl.0000000000010752}
}
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record names 8 authors; APA and Vancouver show the first six, BibTeX and the downloads carry all of them. Check the citation against the original before you use it.
Key findings
- We estimated pooled prevalence of HAND by a random effects model and evaluated its overall burden worldwide.
- Results Of 5,588 records identified, we included 123 studies involving 35,513 participants from 32 countries.
- The overall prevalence of HAND was 42.6% (95% confidence interval [CI] 39.7-45.5) and did not differ with respect to diagnostic criteria used.
- The prevalence of HAND was significantly associated with the level of CD4 nadir, with a prevalence of HAND higher in low CD4 nadir groups (mean/median CD4 nadir <200 45.2% [40.5-49.9]) vs the high CD4 nadir group (mean/median CD4 nadir ≥200 37.1% [32.7-41.7]).
Why it matters
This meta-analysis estimated that HIV-associated neurocognitive disorder affected 42.6% of people living with HIV across the included studies. It found the prevalence was higher in groups with lower CD4 nadir, indicating a high burden of this condition in the antiretroviral therapy era.
New to this subject? Start with our plain-English guide: Caregiving →
Study details
- Study designcohort study
- Participants123
- Effect size42.6%; 23.5%; 13.3%
- Evidence strengthModerate
How this study scored 75/100
Published in a leading specialty journal, and it is a meta-analysis pooling many studies.
| Component | Points | Why |
|---|---|---|
| Journal tier | 9 / 10 | Tier 2 — leading specialty journal (Neurology) |
| Journal's citation record | 4 / 4 | Neurology: journal h-index 525 (OpenAlex, 2026-10-29) |
| Study design | 12 / 12 | A meta-analysis pooling many studies (from PubMed type “Meta-Analysis”) |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 2 / 5 | 2020 — within 10 year(s) of the newest study here |
| Sample size | 2 / 4 | 123 participants |
| Effect reported | 2 / 3 | Effect reported as a number, without an interval or test |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomized / blinded | 0 / 2 | A review of other studies — randomization is not credited here |
| Times cited | 6 / 7 | Cited 351 times (OpenAlex, 2026-10-10) |
| Citations per year | 4 / 5 | 43.9 citations a year over 8 year(s) since 2020 |
| Impact for its field and year | 5 / 6 | Cited 20.7× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 2 / 6 | Cited by 4 other studies in this library |
| Still being cited | 3 / 4 | Cited 184 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 3 / 4 | Last-listed author Yanping Bao: h-index 61 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | UNSW Sydney: institution h-index 1,101 (OpenAlex) |
| Multicenter collaboration | 2 / 3 | OpenAlex lists 5 institution(s) in 2 countries |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 32887786) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 75 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
May need a subscription OpenAlex found no free copy of the full text (checked 6 Feb 1020), so the publisher may charge for it. The PubMed abstract is free.
Related
Studies in the library that share something with this one. The line above each title says what.
Studies this one cites
Referenced by this study and also in the alzhub library, so you can read them here.
Later studies that cite this one
4 studies in the alzhub library list this one in their references.
Related studies in Caregiving
Also tagged “mini-mental”
840 studies in the library carry the topic tag “mini-mental”; these are this study's neighbours in a fixed, alphabetical-by-hash tour of them, not the closest in content. All 840 tagged studies.