The Montreal Cognitive Assessment-Basic (MoCA-B) is not a reliable screening tool for cognitive decline in HIV patients receiving combination antiretroviral therapy in rural South Africa.

Journal: International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases

Volume: 67

Issue: 

Year of Publication: 2018

Affiliated Institutions:  Department of Internal Medicine and Infectious Diseases, University Medical Center Utrecht (UMCU), Utrecht, The Netherlands; Utrecht University, Utrecht, The Netherlands. Electronic address: c.s.hakkers@umcutrecht.nl. Department of Internal Medicine and Infectious Diseases, University Medical Center Utrecht (UMCU), Utrecht, The Netherlands. Department of Neuropsychology, University Medical Center Utrecht (UMCU), Utrecht, The Netherlands. Department of Internal Medicine and Infectious Diseases, University Medical Center Utrecht (UMCU), Utrecht, The Netherlands; Utrecht University, Utrecht, The Netherlands. Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht (UMCU), Utrecht, The Netherlands; Ndlovu Care Group in Elandsdoorn, Limpopo, South Africa. Ndlovu Care Group in Elandsdoorn, Limpopo, South Africa. Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht (UMCU), Utrecht, The Netherlands.

Abstract summary 

HIV-associated neurocognitive disorders (HAND) are frequently occurring comorbidities in HIV-positive patients, diagnosed by means of a neuropsychological assessment (NPA). Due to the magnitude of the HIV-positive population in Sub-Saharan Africa, easy-to-use cognitive screening tools are essential.This was a cross-sectional clinical trial involving 44 HIV-positive patients (on stable cART) and 73 HIV-negative controls completing an NPA, the International HIV Dementia Scale (IHDS), and a culturally appropriate cognitive screening tool, the Montreal Cognitive Assessment-Basic (MoCA-B). HAND were diagnosed by calculating Z-scores using internationally published normative data on NPA, as well as by using data from the HIV-negative group to validate the MoCA-B.One hundred and seventeen patients were included (25% male, median age 35 years, median 11 years of education). A moderate correlation was found between the MoCA-B and NPA total Z-score (Pearson's r=0.36, p=0.02). Area under the curve (AUC) values for MoCA-B and IHDS were 0.59 and 0.70, respectively. The prevalence of HAND in HIV-positive patients was 66% when calculating Z-scores using published normative data versus 48% when using the data from the present HIV-negative cohort.The MoCA-B appeared not to be a valid screening tool for HAND in this setting. The prevalence of HAND in this setting is high, but appeared overestimated when using published norms.

Authors & Co-authors:  Hakkers C S CS Beunders A J M AJM Ensing M H M MHM Barth R E RE Boelema S S Devillé W L J WLJ Tempelman H A HA Coutinho R A RA Hoepelman A I M AIM Arends J E JE van Zandvoort M J E MJE

Study Outcome 

Source Link: Visit source

Statistics
Citations : 
Authors :  11
Identifiers
Doi : 10.1016/j.ijid.2017.11.024
SSN : 1878-3511
Study Population
Male,Female
Mesh Terms
AIDS Dementia Complex
Other Terms
Africa;HAND;HIV;MoCA;Screening
Study Design
Cross Sectional Study
Study Approach
Country of Study
South Africa
Publication Country
Canada