HIV-associated neurocognitive disorder in HIV-infected Koreans: the Korean NeuroAIDS Project
Version of Record online: 24 FEB 2014
© 2014 British HIV Association
Volume 15, Issue 8, pages 470–477, September 2014
How to Cite
Ku, N., Lee, Y., Ahn, J., Song, J., Kim, M., Kim, S., Jeong, S., Hong, K.-W., Kim, E., Han, S., Song, J., Cheong, H., Song, Y., Kim, W., Kim, J., Smith, D. and Choi, J. (2014), HIV-associated neurocognitive disorder in HIV-infected Koreans: the Korean NeuroAIDS Project. HIV Medicine, 15: 470–477. doi: 10.1111/hiv.12137
- Issue online: 19 AUG 2014
- Version of Record online: 24 FEB 2014
- Manuscript Accepted: 9 JAN 2014
- National Research Foundation of Korea (NRF). Grant Numbers: NRF-2013R1A1A2005412, NRF-2011-220-E00015
- Korea Centers for Disease Control and Prevention. Grant Number: 4800-4859-304-260
- Korean Society for AIDS
- US National Institutes of Health (NIH). Grant Numbers: AI100665, AI36214, MH097520, MH83552, MH62512
- HIV-associated neurocognitive disorder (HAND);
- neuropsychological tests;
- risk factors;
- screening tool
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.
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.
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 ≤ 13 g/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.
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.