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HIV ‐associated neurocognitive disorder in HIV ‐infected K oreans: the K orean N euro AIDS P roject
Author(s) -
Ku NS,
Lee Y,
Ahn JY,
Song JE,
Kim MH,
Kim SB,
Jeong SJ,
Hong KW,
Kim E,
Han SH,
Song JY,
Cheong HJ,
Song YG,
Kim WJ,
Kim JM,
Smith DM,
Choi JY
Publication year - 2014
Publication title -
hiv medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.53
H-Index - 79
eISSN - 1468-1293
pISSN - 1464-2662
DOI - 10.1111/hiv.12137
Subject(s) - medicine , neurocognitive , montreal cognitive assessment , asymptomatic , neuropsychology , human immunodeficiency virus (hiv) , dementia , immunology , psychiatry , cognition , disease
Objectives HIV ‐associated neurocognitive disorder ( HAND ) is an independent predictor of early mortality and is associated with many difficulties in activities of daily living. We sought to determine the prevalence of and risk factors for HAND in HIV ‐infected K oreans. In addition, we investigated the performance of screening tools and components of neuropsychological ( NP ) tests for diagnosing HAND . Methods HIV ‐infected patients were enrolled consecutively from two different urban teaching hospitals in S eoul, S outh K orea between M arch 2012 and S eptember 2012. Participants completed a detailed NP assessment of six cognitive domains commonly affected by HIV . The F rascati criteria were used for diagnosing HAND . Four key questions, the International HIV D ementia S cale ( IHDS ) and M ontreal C ognitive A ssessment ( MoCA )‐ K were also assessed as potential tools for screening for HAND . Results Among the 194 participants, the prevalence of HAND was 26.3%. Asymptomatic neurocognitive impairment and minor neurocognitive disorder accounted for 52.9 and 47.1% of the patients with HAND , respectively. In multivariate analysis, haemoglobin ( Hb ) level ≤ 13 g/dL ( P = 0.046) and current use of a protease inhibitor‐based regimen ( P = 0.031) were independent risk factors for HAND . The sensitivity and specificity of the IHDS were 72.6 and 60.8%, and those of MoCA‐K were 52.9 and 73.4%, respectively. The IHDS ( P < 0.001) and MoCA‐K ( P < 0.001) were both useful for screening for HAND . Among NP tests, the sensitivity and specificity of the G rooved P egboard T est were 90.2 and 72.0%, and those of the W isconsin C ard S orting T est were 61.2 and 84.4%, respectively. Conclusions HAND is a prevalent comorbidity in HIV ‐infected K oreans. Active screening and diagnosis with effective tools, such as the IHDS , MoCA‐K and G rooved P egboard T est, could be used to identify this important complication.