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Please use this identifier to cite or link to this item: http://hdl.handle.net/1959.14/1201695
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- Title
- A Screening strategy for HIV-associated neurocognitive disorders that accurately identifies patients requiring neurological review
- Related
- Clinical infectious diseases, Vol. 63, Issue 5, (2016), p.687-693
- DOI
- 10.1093/cid/ciw399
- Publisher
- Oxford University Press
- Date
- 2016
- Author/Creator
- Bloch, Mark
- Author/Creator
- Kamminga, Jody
- Author/Creator
- Jayewardene, Avindra
- Author/Creator
- Bailey, Michael
- Author/Creator
- Carberry, Angela
- Author/Creator
- Vincent, Trina
- Author/Creator
- Quan, Dick
- Author/Creator
- Maruff, Paul
- Author/Creator
- Brew, Bruce
- Author/Creator
- Cysique, Lucette A
- Description
- Background. Human immunodeficiency virus (HIV)–associated neurocognitive disorders (HAND) are not routinely assessed due to the lack of an adequate screening strategy. We aimed to develop a clinically relevant screening procedure for symptomatic HAND, validated against a gold standard neuropsychological (NP) test battery. Methods. Representative HIV-infected (HIV+) and demographically matched HIV-uninfected (HIV−) participants in an observational study completed a standard evaluation for mood, drug and/or alcohol use, and activities of daily living and a newly designed 20-minute computerized CogState battery that assessed 5 cognitive domains. A subset completed standard NP assessment for 8 cognitive domains. HAND definition on screening and gold standard NP was determined using demographically corrected z scores and the global deficit score (≥ 0.5), applying the Frascati criteria. Participants were blinded to screening results, and the NP examiner was blinded to screening and HIV status. Results. A total of 254 HIV+ participants were enrolled—mean age, 48.9 ± 10.2 years; median nadir CD4, 270 cells/mL; tertiary educated, 54%; and HIV− controls, 72. HIV+ HAND screening prevalence was 30.7% (HIV-associated dementia, 3.2%; mild neurocognitive disorder, 12.6%; and asymptomatic neurocognitive disorder, 15.0%; HIV− group: 13.9%; P = .004). Of the 75 participants who completed the NP battery, the HAND rate in the HIV+ group was 50.9% vs 43.4% by screening (P > .50). HAND screening vs gold standard NP sensitivity was 76% and specificity was 71%. Clinically relevant HIV-associated dementia and mild neurocognitive disorder sensitivity was 100% and specificity was 98% (positive predictive value 0.92). Conclusions. Symptomatic HAND warranting neurological review was accurately predicted using a CogState-based screening procedure.
- Description
- 7 page(s)
- Subject Keyword
- HIV
- Subject Keyword
- HAND
- Subject Keyword
- neurocognitive screening
- Resource Type
- journal article
- Organisation
- Macquarie University. Department of Psychology
- Identifier
- http://hdl.handle.net/1959.14/1201695
- Identifier
- mq:62360
- Identifier
- ISSN:1058-4838
- Identifier
- mq-rm-2014007742
- Identifier
- mq_res-se-566456
- Language
- eng
- Reviewed
Macquarie University ResearchOnline
