The Veterans Aging Cohort Study Index is not associated with HIV-associated neurocognitive disorders in Uganda

Awori, Violet; Nakigozi, Gertrude; Kisakye, Alice; Batte, James; Anok, Aggrey; Mayanja, Richard; Nakasujja, Noeline; Robertson, Kevin; Gray, Ronald H.; Wawer, Maria J.; Sacktor, Ned; Saylor, Deanna

doi:10.1007/s13365-019-00806-2

Cited by 3 publications

(3 citation statements)

References 24 publications

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“…The major weakness of this study is the use of a combination of two brief Neurocognitive tests to ascertain global Neurocognitive impairment. The rates of global NCI in other similar studies testing this association were 40% [ 3 ] and 51% [ 31 ] whereas in our study it was much higher at 71.1%. Furthermore, MoCA has not been validated for domain-wise testing of NCI, hence the associations between VACS and various cognitive domains needs to be further researched upon with comprehensive neurocognitive testing tools.…”

Section: Discussioncontrasting

confidence: 62%

Association between Veterans Aging Cohort Study (VACS) index and neurocognitive function among people living with HIV–a cross sectional study in coastal South India

et al. 2021

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Background HIV is an infectious disease affecting 36.7 million people worldwide. In recent times, Antiretroviral Therapy (ART) has become accessible to the majority of People Living with HIV (PLHIV) and this has transformed the course of infection to one that is chronic, characterized by fewer diseases pathognomonic of AIDS. In view of this, there is a pressing need for better markers, apart from the routine HIV indicators, to detect comorbidities such as Neurocognitive Impairment (NCI). The aim of this study was to find out the association between Veterans Aging Cohort Study (VACS) index and Neurocognitive function in HIV positive patients. Methods In our study, we included 97 HIV positive patients and their Neurocognitive function was assessed using a combination of Montreal Cognitive Assessment and Grooved Pegboard Test, while VACS index was calculated using the most recent laboratory values. Binomial Logistics Regression analyses, adjusting for potential confounding variables, was performed to determine the association between VACS score and Neurocognitive Impairment. Results We found that a higher VACS Index was associated with global and domain-wise Neurocognitive impairment (p < 0.01), specifically in the domains of attention (p < 0.01) and fine motor skills (p = 0.01). Our study also showed that among all the VACS components, older age (p = 0.02) and lower hemoglobin (p < 0.01) values were associated with global NCI. After plotting an ROC curve, a VACS cut-off score of 11.00 was identified as it had good sensitivity (87.0%) and specificity (71.4%) in identifying Global NCI. Conclusion Our findings extend prior research on the use of VACS Index to predict global and domain-wise NCI in HIV-positive patients. However, further research with more comprehensive neurocognitive testing is required in our setting before VACS Index can be used as a tool to screen for neurocognitive dysfunction among PLHIV.

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Section: Discussioncontrasting

confidence: 62%

Association between Veterans Aging Cohort Study (VACS) index and neurocognitive function among people living with HIV–a cross sectional study in coastal South India

et al. 2021

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“…A major objective of the study was to test the correlation between neurocognitive function with rCBF and rCMRO 2 measured by MRI in PLHIV. For the purposes of cross-sectional analysis, the participants were grouped as symptomatic or disabling HAND (HAD and MND), asymptomatic or non-disabling HAND (ANI) and normal HAND [44]…”

Section: Discussionmentioning

confidence: 99%

“…A major objective of the study was to test the correlation between neurocognitive function with rCBF and rCMRO 2 measured by MRI in PLHIV. For the purposes of cross‐sectional analysis, the participants were grouped as symptomatic or disabling HAND (HAD and MND), asymptomatic or non‐disabling HAND (ANI) and normal HAND [44] compared with age‐, gender‐ and race‐matched controls. Continuous variables were first assessed for normal distribution and appropriateness of using the independent sample t test when two groups were compared and analysis of variance (ANOVA) when more than two groups were compared.…”

Section: Methodsmentioning

confidence: 99%

Reduction in cerebral oxygen metabolism in subcortical regions may be a biomarker of cognitive decline in people living with human immunodeficiency virus

Sen

Sollman

et al. 2021

Euro J of Neurology

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Background and purpose: Regional cerebral blood flow (rCBF) and oxygen metabolism (rCMRO 2 ) in whole brain, white matter, gray matter and lenticular nuclei were studied in people living with human immunodeficiency virus (PLHIV) as well as HIV-associated neurocognitive disorder (HAND).Methods: Treatment-naïve PLHIV underwent neurocognitive assessment and magnetic resonance (MR) measurement of rCBF and rCMRO 2 with repeat after 12 months of antiretroviral therapy (ART). Age-and sex-matched controls underwent single MR measurements. Regional CBF and rCMRO 2 were compared amongst symptomatic, asymptomatic, normal HAND and controls using analysis of variance. Longitudinal analysis of HAND worsening (≥1 category) was assessed after 12 months of ART and correlated with rCBF and rCMRO 2 measured by MR imaging using the paired-sample t test.Results: Thirty PLHIV completed baseline and 12-month assessments (29 with rCMRO 2 measurement). At baseline HAND assessment, 13% had no cognitive impairment, 27% had asymptomatic neurocognitive impairment, 60% had mild neurocognitive disorder and none had HIV-associated dementia. At 12 months, 13% had no cognitive impairment, 20% had asymptomatic neurocognitive impairment, 50% had mild neurocognitive disorder and 17% had HIV-associated dementia. In those without HAND worsening (N = 21) rCMRO 2 remained stable and in those with HAND worsening (N = 8) rCMRO 2 measurement declined from baseline to 12 months in white matter (2.05 ± 0.40 to 1.73 ± 0.51, p = 0.03) and lenticular nuclei (4.32 ± 0.39 to 4.00 ± 0.51, p = 0.05). Conclusions:In recently diagnosed PLHIV, no association was found between rCBF or rCMRO 2 and cognitive impairment at baseline. There was a reduction in rCMRO 2 in those with worsening of cognitive function at 12 months on ART. Reduction in rCMRO 2 may be a biomarker of cognitive decline in PLHIV.

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Screening Accuracy of Mini Addenbrooke’s Cognitive Examination Test for HIV-Associated Neurocognitive Disorders in People Ageing with HIV

et al. 2022

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The Veterans Aging Cohort Study Index is not associated with HIV-associated neurocognitive disorders in Uganda

Cited by 3 publications

References 24 publications

Association between Veterans Aging Cohort Study (VACS) index and neurocognitive function among people living with HIV–a cross sectional study in coastal South India

Association between Veterans Aging Cohort Study (VACS) index and neurocognitive function among people living with HIV–a cross sectional study in coastal South India

Reduction in cerebral oxygen metabolism in subcortical regions may be a biomarker of cognitive decline in people living with human immunodeficiency virus

Screening Accuracy of Mini Addenbrooke’s Cognitive Examination Test for HIV-Associated Neurocognitive Disorders in People Ageing with HIV

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