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In sub-Saharan Africa SSA , the clinical and progressive diagnostic certainty of AIDS dementia is difficult to establish due to under-medicalization and delays in consultation and especially the diversity of etiologies of demented states. We carried out a retrospective study of patients hospitalized for dementia syndrome between and in the neurology department of the University Hospital of Conakry.
HIV etiology was identified in patients aged 44—67 years 17 women and 19 men. The clinical picture was dominated by severe cognitive disorders, slowed ideation, memory disorders and reduced motor skills associated with personality changes. Neurological examination revealed dysphoric disorders in most patients, sphincter abnormalities in 13 cases and labio-lingual tremor in 11 cases.
Magnetic resonance imaging contributed to the diagnosis, showing diffuse white matter abnormalities with hyper signals on T2-weighted or FLAIR sequences. This study shows a non-stereotype clinical picture of AIDS dementia requiring a differential diagnosis with other infectious dementias. These results are important for the therapeutic and prognostic discussion. The existence of cognitive disorders associated with HIV infection is now a well-established fact since the early publications of Janssen in [ 1 ], Marder et al.
In Guinea, the prevalence of HIV is 2. In Guinea, the outbreak of the Ebola epidemic in [ 9 , 10 ], followed recently by that of COVID, has led to a decline in HIV and syphilis screening, due to the dysfunction of the medical system, which is responsible for the under-reporting of sexually transmitted diseases. Thus, in Guinea, alongside the classic neurological and psychiatric forms described with a high prevalence in sub-Saharan Africa: HIV encephalitis, toxoplasmosis, cerebrovascular accidents, progressive multifocal leukoencephalopathy [ 7 , 8 ], we are witnessing the emergence of forms of progressive cognitive decline due to lax screening and prevention caused by the emergence of other epidemics.
