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Open Access Research article

A short tool to screen HIV-infected patients for mild neurocognitive disorders – a pilot study

Dominique Fasel1, Ursula Kunze2, Luigia Elzi1, Vreni Werder1, Susanne Niepmann1, Andreas U Monsch2, Rahel Schumacher2 and Manuel Battegay1*

Author Affiliations

1 Division of Infectious Diseases & Hospital Epidemiology, University Hospital Basel, Petersgraben 4, Basel 4031, Switzerland

2 Memory Clinic, Department of Geriatrics, University Hospital, Basel, Switzerland

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BMC Psychology 2014, 2:21  doi:10.1186/2050-7283-2-21

Published: 18 July 2014

Abstract

Background

We aimed to evaluate the accuracy and acceptability of a short screening test battery for mild neurocognitive deficits.

Methods

HIV-infected individuals with a suppressed viral load were examined at the University Hospital Basel with a screening test consisting of a questionnaire and selected cognitive tests, administered by trained nurses, followed by an in-depth neuropsychological examination. Test acceptance was evaluated with a questionnaire.

Results

30 patients were included in this study (median age of 52.5 years (interquartile range (IQR) 47–64), prior AIDS-defining condition in 37%, median CD4 cell count 658 (IQR 497–814) cells/μl). Overall, 25 (83%) patients were diagnosed with HIV-associated neurocognitive disorders (HAND) on in-depth neuropsychological assessment (16 patients had asymptomatic neurocognitive impairment (ANI), 8 a mild neurocognitive disorder (MND) and 1 patient HIV-associated dementia (HAD). Among 25 patients with HAND, only 9 patients (36%) were complaining of memory loss. The screening battery revealed neurocognitive deficits in 17 (57%) patients (sensitivity 64%, specificity 80%, positive predictive value 94% and negative predictive value 31%). Most patients (83%) estimated the screening test as valuable and not worrisome.

Conclusions

A questionnaire combined with selected neuropsychological tests is a short, easy-to-perform very well accepted screening tool for mild neurocognitive disorders in asymptomatic HIV-infected individuals.