HIV-associated neurocognitive disorder in HIV-infected Koreans

The Korean NeuroAIDS Project

N. S. Ku, Y. Lee, J. Y. Ahn, J. E. Song, M. H. Kim, S. B. Kim, S. J. Jeong, K. W. Hong, E. Kim, S. H. Han, J. Y. Song, H. J. Cheong, Y. G. Song, W. J. Kim, J. M. Kim, D. M. Smith, JunYong Choi

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Objectives: HIV-associated neurocognitive disorder (HAND) is an independent predictor of early mortality and is associated with many difficulties in activities of daily living. We sought to determine the prevalence of and risk factors for HAND in HIV-infected Koreans. In addition, we investigated the performance of screening tools and components of neuropsychological (NP) tests for diagnosing HAND. Methods: HIV-infected patients were enrolled consecutively from two different urban teaching hospitals in Seoul, South Korea between March 2012 and September 2012. Participants completed a detailed NP assessment of six cognitive domains commonly affected by HIV. The Frascati criteria were used for diagnosing HAND. Four key questions, the International HIV Dementia Scale (IHDS) and Montreal Cognitive Assessment (MoCA)-K were also assessed as potential tools for screening for HAND. Results: Among the 194 participants, the prevalence of HAND was 26.3%. Asymptomatic neurocognitive impairment and minor neurocognitive disorder accounted for 52.9 and 47.1% of the patients with HAND, respectively. In multivariate analysis, haemoglobin (Hb) level ≤13g/dL (P=0.046) and current use of a protease inhibitor-based regimen (P=0.031) were independent risk factors for HAND. The sensitivity and specificity of the IHDS were 72.6 and 60.8%, and those of MoCA-K were 52.9 and 73.4%, respectively. The IHDS (P<0.001) and MoCA-K (P<0.001) were both useful for screening for HAND. Among NP tests, the sensitivity and specificity of the Grooved Pegboard Test were 90.2 and 72.0%, and those of the Wisconsin Card Sorting Test were 61.2 and 84.4%, respectively. Conclusions: HAND is a prevalent comorbidity in HIV-infected Koreans. Active screening and diagnosis with effective tools, such as the IHDS, MoCA-K and Grooved Pegboard Test, could be used to identify this important complication.

Original languageEnglish
Pages (from-to)470-477
Number of pages8
JournalHIV Medicine
Volume15
Issue number8
DOIs
Publication statusPublished - 2014 Jan 1

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HIV
AIDS Dementia Complex
Neuropsychological Tests
Neurocognitive Disorders
Sensitivity and Specificity
Republic of Korea
Urban Hospitals
Activities of Daily Living
Protease Inhibitors
Teaching Hospitals
Comorbidity
Hemoglobins
Multivariate Analysis
Mortality

All Science Journal Classification (ASJC) codes

  • Health Policy
  • Infectious Diseases
  • Pharmacology (medical)

Cite this

Ku, N. S. ; Lee, Y. ; Ahn, J. Y. ; Song, J. E. ; Kim, M. H. ; Kim, S. B. ; Jeong, S. J. ; Hong, K. W. ; Kim, E. ; Han, S. H. ; Song, J. Y. ; Cheong, H. J. ; Song, Y. G. ; Kim, W. J. ; Kim, J. M. ; Smith, D. M. ; Choi, JunYong. / HIV-associated neurocognitive disorder in HIV-infected Koreans : The Korean NeuroAIDS Project. In: HIV Medicine. 2014 ; Vol. 15, No. 8. pp. 470-477.
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title = "HIV-associated neurocognitive disorder in HIV-infected Koreans: The Korean NeuroAIDS Project",
abstract = "Objectives: HIV-associated neurocognitive disorder (HAND) is an independent predictor of early mortality and is associated with many difficulties in activities of daily living. We sought to determine the prevalence of and risk factors for HAND in HIV-infected Koreans. In addition, we investigated the performance of screening tools and components of neuropsychological (NP) tests for diagnosing HAND. Methods: HIV-infected patients were enrolled consecutively from two different urban teaching hospitals in Seoul, South Korea between March 2012 and September 2012. Participants completed a detailed NP assessment of six cognitive domains commonly affected by HIV. The Frascati criteria were used for diagnosing HAND. Four key questions, the International HIV Dementia Scale (IHDS) and Montreal Cognitive Assessment (MoCA)-K were also assessed as potential tools for screening for HAND. Results: Among the 194 participants, the prevalence of HAND was 26.3{\%}. Asymptomatic neurocognitive impairment and minor neurocognitive disorder accounted for 52.9 and 47.1{\%} of the patients with HAND, respectively. In multivariate analysis, haemoglobin (Hb) level ≤13g/dL (P=0.046) and current use of a protease inhibitor-based regimen (P=0.031) were independent risk factors for HAND. The sensitivity and specificity of the IHDS were 72.6 and 60.8{\%}, and those of MoCA-K were 52.9 and 73.4{\%}, respectively. The IHDS (P<0.001) and MoCA-K (P<0.001) were both useful for screening for HAND. Among NP tests, the sensitivity and specificity of the Grooved Pegboard Test were 90.2 and 72.0{\%}, and those of the Wisconsin Card Sorting Test were 61.2 and 84.4{\%}, respectively. Conclusions: HAND is a prevalent comorbidity in HIV-infected Koreans. Active screening and diagnosis with effective tools, such as the IHDS, MoCA-K and Grooved Pegboard Test, could be used to identify this important complication.",
author = "Ku, {N. S.} and Y. Lee and Ahn, {J. Y.} and Song, {J. E.} and Kim, {M. H.} and Kim, {S. B.} and Jeong, {S. J.} and Hong, {K. W.} and E. Kim and Han, {S. H.} and Song, {J. Y.} and Cheong, {H. J.} and Song, {Y. G.} and Kim, {W. J.} and Kim, {J. M.} and Smith, {D. M.} and JunYong Choi",
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Ku, NS, Lee, Y, Ahn, JY, Song, JE, Kim, MH, Kim, SB, Jeong, SJ, Hong, KW, Kim, E, Han, SH, Song, JY, Cheong, HJ, Song, YG, Kim, WJ, Kim, JM, Smith, DM & Choi, J 2014, 'HIV-associated neurocognitive disorder in HIV-infected Koreans: The Korean NeuroAIDS Project', HIV Medicine, vol. 15, no. 8, pp. 470-477. https://doi.org/10.1111/hiv.12137

HIV-associated neurocognitive disorder in HIV-infected Koreans : The Korean NeuroAIDS Project. / Ku, N. S.; Lee, Y.; Ahn, J. Y.; Song, J. E.; Kim, M. H.; Kim, S. B.; Jeong, S. J.; Hong, K. W.; Kim, E.; Han, S. H.; Song, J. Y.; Cheong, H. J.; Song, Y. G.; Kim, W. J.; Kim, J. M.; Smith, D. M.; Choi, JunYong.

In: HIV Medicine, Vol. 15, No. 8, 01.01.2014, p. 470-477.

Research output: Contribution to journalArticle

TY - JOUR

T1 - HIV-associated neurocognitive disorder in HIV-infected Koreans

T2 - The Korean NeuroAIDS Project

AU - Ku, N. S.

AU - Lee, Y.

AU - Ahn, J. Y.

AU - Song, J. E.

AU - Kim, M. H.

AU - Kim, S. B.

AU - Jeong, S. J.

AU - Hong, K. W.

AU - Kim, E.

AU - Han, S. H.

AU - Song, J. Y.

AU - Cheong, H. J.

AU - Song, Y. G.

AU - Kim, W. J.

AU - Kim, J. M.

AU - Smith, D. M.

AU - Choi, JunYong

PY - 2014/1/1

Y1 - 2014/1/1

N2 - Objectives: HIV-associated neurocognitive disorder (HAND) is an independent predictor of early mortality and is associated with many difficulties in activities of daily living. We sought to determine the prevalence of and risk factors for HAND in HIV-infected Koreans. In addition, we investigated the performance of screening tools and components of neuropsychological (NP) tests for diagnosing HAND. Methods: HIV-infected patients were enrolled consecutively from two different urban teaching hospitals in Seoul, South Korea between March 2012 and September 2012. Participants completed a detailed NP assessment of six cognitive domains commonly affected by HIV. The Frascati criteria were used for diagnosing HAND. Four key questions, the International HIV Dementia Scale (IHDS) and Montreal Cognitive Assessment (MoCA)-K were also assessed as potential tools for screening for HAND. Results: Among the 194 participants, the prevalence of HAND was 26.3%. Asymptomatic neurocognitive impairment and minor neurocognitive disorder accounted for 52.9 and 47.1% of the patients with HAND, respectively. In multivariate analysis, haemoglobin (Hb) level ≤13g/dL (P=0.046) and current use of a protease inhibitor-based regimen (P=0.031) were independent risk factors for HAND. The sensitivity and specificity of the IHDS were 72.6 and 60.8%, and those of MoCA-K were 52.9 and 73.4%, respectively. The IHDS (P<0.001) and MoCA-K (P<0.001) were both useful for screening for HAND. Among NP tests, the sensitivity and specificity of the Grooved Pegboard Test were 90.2 and 72.0%, and those of the Wisconsin Card Sorting Test were 61.2 and 84.4%, respectively. Conclusions: HAND is a prevalent comorbidity in HIV-infected Koreans. Active screening and diagnosis with effective tools, such as the IHDS, MoCA-K and Grooved Pegboard Test, could be used to identify this important complication.

AB - Objectives: HIV-associated neurocognitive disorder (HAND) is an independent predictor of early mortality and is associated with many difficulties in activities of daily living. We sought to determine the prevalence of and risk factors for HAND in HIV-infected Koreans. In addition, we investigated the performance of screening tools and components of neuropsychological (NP) tests for diagnosing HAND. Methods: HIV-infected patients were enrolled consecutively from two different urban teaching hospitals in Seoul, South Korea between March 2012 and September 2012. Participants completed a detailed NP assessment of six cognitive domains commonly affected by HIV. The Frascati criteria were used for diagnosing HAND. Four key questions, the International HIV Dementia Scale (IHDS) and Montreal Cognitive Assessment (MoCA)-K were also assessed as potential tools for screening for HAND. Results: Among the 194 participants, the prevalence of HAND was 26.3%. Asymptomatic neurocognitive impairment and minor neurocognitive disorder accounted for 52.9 and 47.1% of the patients with HAND, respectively. In multivariate analysis, haemoglobin (Hb) level ≤13g/dL (P=0.046) and current use of a protease inhibitor-based regimen (P=0.031) were independent risk factors for HAND. The sensitivity and specificity of the IHDS were 72.6 and 60.8%, and those of MoCA-K were 52.9 and 73.4%, respectively. The IHDS (P<0.001) and MoCA-K (P<0.001) were both useful for screening for HAND. Among NP tests, the sensitivity and specificity of the Grooved Pegboard Test were 90.2 and 72.0%, and those of the Wisconsin Card Sorting Test were 61.2 and 84.4%, respectively. Conclusions: HAND is a prevalent comorbidity in HIV-infected Koreans. Active screening and diagnosis with effective tools, such as the IHDS, MoCA-K and Grooved Pegboard Test, could be used to identify this important complication.

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U2 - 10.1111/hiv.12137

DO - 10.1111/hiv.12137

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