Publication Abstract Display
Type: Published Manuscript
Title: Improving detection of HIV-associated cognitive impairment: Comparison of the International HIV Dementia Scale and a brief screening battery.
Authors: de Almeida SM, Kamat R, Cherner M, Umlauf A, Ribeiro CE, Paula de Pereira A, Franklin D, Heaton RK, Ellis RJ
Year: 2017
Publication: Journal of Acquired Immune Deficiency Syndromes (1999)
Volume: 74 Issue: 3 Pages: 332-338
Abstract:OBJECTIVES: The International HIV Dementia Scale (IHDS) was developed to screen for HIV-associated dementia (HAD), but it has been used more generally for HIV-associated neurocognitive disorder (HAND). This study sought to examine the accuracy of the IHDS in a cohort of Brazilian HIV-infected individuals and compare its performance to an alternative screening battery for detecting HAND. METHODS: 108 participants (including 60 HIV-infected persons), completed the IHDS and a gold standard neuropsychological (NP) battery of 17 tests. As alternative screening method, all possible three-test combinations from the NP battery were examined and a superiority index (a marker of specificity and sensitivity) was calculated. RESULTS: Sensitivity and specificity to HAND using the standard IHDS cutpoint of 10 were 36% and 75% respectively. The best balance between sensitivity and specificity was accomplished with a modified cutpoint of 11.5, which yielded sensitivity of 72% and specificity of 58%. The top two most sensitive test combinations, compared to the gold standard NP battery, were Trail Making Test A, WAIS-III Digit Symbol (DS) and HVLT-R Total Recall (sensitivity 91%, specificity 96%), and DS, BVMT-R Total Recall and Grooved Pegboard Test-Dominant Hand (sensitivity 94%, specificity 91%). CONCLUSIONS: Both test combinations can be administered in under 10 minutes and were more accurate than the IHDS in classifying HIV+ participants as NP impaired or unimpaired. These data suggest that demographically corrected T-scores from commonly used NP measures with modest time and material demands can improve identification of patients with HAND who may benefit from a more extensive NP examination.

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