Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Mar;19(1):19-27.
doi: 10.12779/dnd.2020.19.1.19. Epub 2019 Dec 24.

Determining the Neurocognitive Status and the Functional Ability of Patients to Screen for HIV-Associated Neurocognitive Disorder (HAND)

Ritika Agarwal  1 , Ravinder Singh Aujla  2 , Amit Gupta  2 , Mukesh Kumar  2
Affiliations

Determining the Neurocognitive Status and the Functional Ability of Patients to Screen for HIV-Associated Neurocognitive Disorder (HAND)

Ritika Agarwal et al. Dement Neurocogn Disord. 2020 Mar.

Abstract

Background and purpose: To adequately evaluate the extent of neurocognitive impairment in patient living with human immunodeficiency virus (PLHIV), a battery of neuropsychological tests is typically administered which are neither cost effective nor time efficient in the outpatient clinical setting. The aim of the study was to assess neurocognitive status and functional ability of people living with HIV and find a brief screening tool to identify those who would benefit from a full diagnostic evaluation.

Methods: The study enrolled 160 PLHIV (80 pre-antiretroviral therapy [ART] and 80 on ART) fulfilling the inclusion and exclusion criteria. Neurocognitive assessment and an assessment of Functional ability was done by using the Montreal Cognitive Assessment (MoCA) and Lawton and Brody Instrumental Activities of Daily Living Scale scale, respectively.

Results: The study population consisted of 75.6% males and 24.4% females with mean age of 44±10 years. The overall prevalence of HIV associated neurocognitive disorder (HAND) in the study subjects was 52.5%. Of these, 47.5% had asymptomatic neurocognitive impairment and 5% had minor neurocognitive disorder. In MoCA, the most frequently affected domains were Language (97.6%), visuospatial ability (92.9%) and memory (71.4%).

Conclusions: The prevalence of HAND in both groups were similar suggesting that neurocognitive impairment starts early in HIV infection. Memory and Visuospatial function impairment had the most predictive potential for detecting the presence of HAND. HAND screening is recommended in all PLHIV at enrolment into care. Simple tools like MoCA can be used in busy outpatient settings by healthcare workers to screen for HAND.

Keywords: Dementia: HAND; HIV; Neurocognitive Assessment; Neurocognitive Disorder.

PubMed Disclaimer

Conflict of interest statement

The authors have no financial conflicts of interest.

References

    1. Fauci AS, Lane HC. Human immunodeficiency virus disease: AIDS and related disorders. In: Longo DL, Kasper MD, Jameson JL, Fauci AS, Hauser SL, Loscalzo J, editors. Harrison's Principles of Internal Medicine. 18th ed. New York: McGraw-Hill Companies; 2011. pp. 1506–1587.
    1. Antinori A, Arendt G, Becker JT, Brew BJ, Byrd DA, Cherner M, et al. Updated research nosology for HIV-associated neurocognitive disorders. Neurology. 2007;69:1789–1799. - PMC - PubMed
    1. Gisslén M, Price RW, Nilsson S. The definition of HIV-associated neurocognitive disorders: are we overestimating the real prevalence? BMC Infect Dis. 2011;11:356. - PMC - PubMed
    1. Valcour V, Paul R, Chiao S, Wendelken LA, Miller B. Screening for cognitive impairment in human immunodeficiency virus. Clin Infect Dis. 2011;53:836–842. - PMC - PubMed
    1. Hasbun R, Eraso J, Ramireddy S, Wainwright DA, Salazar L, Grimes R, et al. Screening for neurocognitive impairment in HIV individuals: the utility of the montreal cognitive assessment test. J AIDS Clin Res. 2012;3:186. - PMC - PubMed