Screening for HIV-Associated Neurocognitive Disorders: Sensitivity and Specificity

Robbins, Reuben N; Scott, Travis M; Gouse, Hetta; Marcotte, Thomas D.; Rourke, Sean B.

doi:10.1007/7854_2019_117

Cited by 15 publications

(30 citation statements)

References 102 publications

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“…Since more PLWH gain access to effective ART, with increased life expectancy, screening for HAND is critical for their health, quality of life, and developing optimal management strategies. 48 , 49 Furthermore, as HIV patients become older, they are at a higher risk of developing dementia compared with the general population. With aging, there is a decline in the incidence of CNS opportunistic infections, which may affect cognition.…”

Section: Screening For Cognitive Impairmentmentioning

confidence: 99%

HIV-Associated Neurocognitive Disorder (HAND): Obstacles to Early Neuropsychological Diagnosis

Vastag¹,

Fira-Mlădinescu²,

Roşca³

2022

IJGM

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Despite the recent advances in HIV treatment, HIV-associated neurocognitive disorder (HAND) prevalence remains high, especially in the mild forms. Current recommendations endorse routine screening for HAND and early identification, but there are several obstacles in diagnosing and managing cognitive impairment in people living with HIV. The purpose of this review is to provide an overview of the concepts and diagnostic tools in the field of HAND and report on the strengths and limitations of currently available approaches.

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Section: Screening For Cognitive Impairmentmentioning

confidence: 99%

HIV-Associated Neurocognitive Disorder (HAND): Obstacles to Early Neuropsychological Diagnosis

Vastag¹,

Fira-Mlădinescu²,

Roşca³

2022

IJGM

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“…In general, we do not recommend the use of IHDS in isolation. A possible solution could consist of using combinations of short tests, including the IHDS, that require 10 to 30 min to complete, enhancing sensitivity and specificity, and could be used in settings with limited resources [ 42 , 58 ]. Further studies could investigate the application of multiple brief screening tests with a full neuropsychological battery to optimize a screening tool that can accurately detect HAND.…”

Section: Discussionmentioning

confidence: 99%

“…One first step essential to the development and implementation of screening and referral programs is research to assess any potential program′s acceptability and feasibility from the patient, provider, and clinic system perspectives. Further, as screening programs are developed and implemented, they will also have to positively impact clinical care and patient outcomes [ 42 ].…”

Section: Discussionmentioning

confidence: 99%

“…Normative corrections (i.e., for age and gender, education, and ethnicity) are not readily available for all populations of HIV patients, or they might be based on a restricted set of demographic factors. This can induce a bias when evaluating cognitive impairment [ 42 , 70 ]. In addition, some other factors may introduce biases, including the total central nervous system penetration-effectiveness (CPE) score, polypharmacy, or medication side effects [ 76 ].…”

Section: Discussionmentioning

confidence: 99%

“…Other general cognitive screening tests, such as Mini-Mental State Examination (MMSE) and MoCA, have been used in clinical practice in various neurological disorders. Although MMSE is widely used as a screening tool for HAND, studies have indicated that it is not very reliable in detecting cognitive impairment in PLWH [ 40 , 41 , 42 , 43 ]. The MoCA has been used in patients with HIV as a screening instrument with variable results.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

International HIV Dementia Scale for HIV-Associated Neurocognitive Disorders: A Systematic Review and Meta-Analysis

Roşca

Tadger²,

Cornea

et al. 2021

Diagnostics

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The present study aims to systematically review the evidence on the accuracy of the International HIV Dementia Scale (IHDS) test for diagnosing human immunodeficiency virus (HIV)-associated neurocognitive disorders (HAND) and outline the quality and quantity of research evidence available on the accuracy of IHDS in people living with HIV. We conducted a systematic literature review, searching five databases from inception until July 2020. We extracted dichotomized positive and negative test results at various thresholds and calculated the sensitivity and specificity of IHDS. Quality assessment was performed according to the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) criteria. Fifteen cross-sectional studies, published between 2011 and 2018, met the inclusion criteria for meta-analysis. Overall, 3760 patients were included, but most studies recruited small samples. We assessed most studies as being applicable to the review question, though we had concerns about the selection of participants in three studies. The accuracy of IHDS was investigated at thirteen cut-off points (scores 6–12). The threshold of 10 is the most useful for optimal HAND screening (including asymptomatic neurocognitive disorder, symptomatic HAND, and HIV-associated dementia) with fair diagnostic accuracy.

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Dementia and HIV infection

Cornea,

Simu,

Rosca

2025

Neuropsychiatric Complications of HIV

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Screening for HIV-Associated Neurocognitive Disorders: Sensitivity and Specificity

Cited by 15 publications

References 102 publications

HIV-Associated Neurocognitive Disorder (HAND): Obstacles to Early Neuropsychological Diagnosis

HIV-Associated Neurocognitive Disorder (HAND): Obstacles to Early Neuropsychological Diagnosis

International HIV Dementia Scale for HIV-Associated Neurocognitive Disorders: A Systematic Review and Meta-Analysis

Dementia and HIV infection

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