Adding a brief self-report cognitive tool to the IHDS improves effectiveness of identifying patients with HIV-associated dementia in South Africa.

Journal: Journal of neurovirology

Volume: 23

Issue: 5

Year of Publication: 2018

Affiliated Institutions:  Department of Psychiatry and Mental Health, HIV Mental Health Research Unit, University of Cape Town, Cape Town, South Africa. hetta.gouse@uct.ac.za. Department of Psychiatry and Mental Health, HIV Mental Health Research Unit, University of Cape Town, Cape Town, South Africa. Division of Clinical Pharmacology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa. Department of Psychology, University of Cape Town, Cape Town, South Africa.

Abstract summary 

We compared the diagnostic accuracy of two brief screening tools (the International HIV Dementia Scale (IHDS), and the IHDS combined with a novel self-report instrument, the HIV Cognitive Symptom Questionnaire (HCSQ)) with that of three brief neuropsychological screening batteries (a 2-, a 3-, and a 4-test battery, each consisting of standardized cognitive tests) in discriminating individuals with HIV-associated dementia (HAD) from those with milder forms of cognitive impairment. We analyzed data from 94 isiXhosa-speaking South African HIV-infected participants who were screened as part of a clinical trial evaluating adjunctive treatment in patients with moderate to severe HIV-associated cognitive impairment. A comprehensive neuropsychological battery diagnosed 53% (50/94) of the participants with HAD. We evaluated the sensitivity and specificity for the screening tools and screening batteries. The brief screening tool performed better compared to the brief neuropsychology battery. The IHDS-HCSQ combination delivered 94% sensitivity and 63% specificity for HAD compared to the IHDS (74 and 70% at a cutoff of ≤8) which offers a viable and quick way to screen for HAD in people living with HIV. It is easy to administer, is time- and cost-efficient, and it appears to be a better option, for these purposes, than brief neuropsychology batteries. It is viable for use in clinical, research, and workplace settings when identification of HIV-infected people with severe cognitive impairment is required.

Authors & Co-authors:  Gouse Hetta H Casson-Crook Martine M Decloedt Eric H EH Joska John A JA Thomas Kevin G F KGF

Study Outcome 

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Statistics
Citations :  AIDS Behav. 2011 Aug;15(6):1197-203
Authors :  5
Identifiers
Doi : 10.1007/s13365-017-0551-y
SSN : 1538-2443
Study Population
Male,Female
Mesh Terms
AIDS Dementia Complex
Other Terms
Cognition;HIV Cognitive Symptom Questionnaire;HIV-associated neurocognitive disorders;International HIV Dementia Scale;Neuropsychology;Screener
Study Design
Cross Sectional Study
Study Approach
Country of Study
South Africa
Publication Country
United States