학술논문

HIV‐associated neurocognitive disorder in HIV‐infected Koreans: the Korean NeuroAIDS Project
Document Type
article
Source
HIV Medicine. 15(8)
Subject
Medical Microbiology
Biomedical and Clinical Sciences
Acquired Cognitive Impairment
Prevention
Neurodegenerative
HIV/AIDS
Neurosciences
Aging
Behavioral and Social Science
Clinical Research
Sexually Transmitted Infections
Mental Health
Infectious Diseases
Brain Disorders
Infection
AIDS Dementia Complex
Adult
Aged
Female
Hospitals
Teaching
Humans
Male
Mass Screening
Middle Aged
Neuropsychological Tests
Prevalence
Republic of Korea
Risk Factors
Sensitivity and Specificity
Young Adult
HIV
HIV-associated neurocognitive disorder
neuropsychological tests
risk factors
screening tool
Neuropsychological tests
Risk factors
Screening tool
Clinical Sciences
Virology
Clinical sciences
Epidemiology
Language
Abstract
ObjectivesHIV-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.MethodsHIV-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.ResultsAmong 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