DOI: 10.5061/dryad.qv9s4mwbq
title: Data from: Global prevalence and burden of HIV-associated neurocognitive disorder: A meta-analysis

description: Objectives: We aimed to characterise the prevalence and burden of 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 Jan 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% CI: 39·7-45·5), and did not differ with respect to diagnostic
 criteria used. The prevalence of asymptomatic neurocognitive impairment
 (ANI), mild neurocognitive disorder (MND) and HIV-associated dementia
 (HAD) 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
 &lt;200: 45·2%, 40·5-49·9) versus high CD4 nadir group (mean/median
 CD4 nadir ≥200: 37·1%, 32·7-41·7). Worldwide, we estimated that there were
 roughly 16145400 (95% CI 15046300-17244500) cases of HAND in HIV-infected
 adults, with 72% in sub-Saharan Africa (11571200 cases, 95% CI
 9600000-13568000). Conclusions: Our findings suggest that people living
 with HIV have a high burden of HAND in the 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.
description: The source data are available from individual articles
 reviewed.
description: Supplementary Table 1: Search strategy for systematic review and
 meta-analysis on the prevalence of HAND in adults with HIV<br>
 Supplementary Table 2: Tool used for risk of bias<br> Supplementary
 Table 3: Characteristics of included studies<br> Supplementary Table
 4: Univariable meta-regression analyses for moderators on prevalence
 estimate of HAND and its subtype in adults with HIV<br>
 Supplementary Table 5: Multivariable meta-regression analyses for
 moderators on prevalence estimate of HAND and its subtype in adults with
 HIV<br> Supplementary Table 6: Sensitivity analysis for study
 quality on prevalence estimate of HAND and its subtype in adults with
 HIV Supplementary Figure 1: Random-effects
 meta-analysis results for prevalence of HAND in HIV-infected adults, by
 diagnostic criteria<br> Supplementary Figure 2: Random-effects
 meta-analysis results for prevalence of ANI according to Frascati criteria
 in HIV-infected adults<br> Supplementary Figure 3: Random-effects
 meta-analysis results for prevalence of MND according to Frascati criteria
 in HIV-infected adults<br> Supplementary Figure 4: Random-effects
 meta-analysis results for prevalence of HAD according to Frascati criteria
 in HIV-infected adults<br> Supplementary Figure 5: Funnel plot and
 asymmetry tests of the pooled estimates of HAND, ANI, MND and
 HAD<br> Supplementary Figure 6: Proportion on ART and current CD4
 count by age group Reference list of included
 studies