Identification of an abbreviated test battery for detection of HIV-associated neurocognitive impairment in an early-managed HIV-infected cohort.

HIV-associated neurocognitive disorders (HAND) remain prevalent despite improved antiretroviral treatment (ART), and it is essential to have a sensitive and specific HAND screening tool.Participants were 200 HIV-infected US military beneficiaries, managed early in the course of HIV infection, had fe...

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Main Authors: David J Moore, Mollie J P Roediger, Lynn E Eberly, Kaitlin Blackstone, Braden Hale, Amy Weintrob, Anuradha Ganesan, Brian K Agan, Scott L Letendre, Nancy F Crum-Cianflone
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2012-01-01
Series:PLoS ONE
Online Access:http://europepmc.org/articles/PMC3493574?pdf=render
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author David J Moore
Mollie J P Roediger
Lynn E Eberly
Kaitlin Blackstone
Braden Hale
Amy Weintrob
Anuradha Ganesan
Brian K Agan
Scott L Letendre
Nancy F Crum-Cianflone
author_facet David J Moore
Mollie J P Roediger
Lynn E Eberly
Kaitlin Blackstone
Braden Hale
Amy Weintrob
Anuradha Ganesan
Brian K Agan
Scott L Letendre
Nancy F Crum-Cianflone
author_sort David J Moore
collection DOAJ
description HIV-associated neurocognitive disorders (HAND) remain prevalent despite improved antiretroviral treatment (ART), and it is essential to have a sensitive and specific HAND screening tool.Participants were 200 HIV-infected US military beneficiaries, managed early in the course of HIV infection, had few comorbidities, and had open access to ART. Participants completed a comprehensive, seven-domain (16-test), neuropsychological battery (∼120 min); neurocognitive impairment (NCI) was determined using a standardized score derived from demographically adjusted T-scores (global deficit score ≥0.5). Restricting the estimated administration time of the screening battery to < = 20 minutes, we examined the sensitivity and specificity of detecting NCI for all possible combinations of 2-, 3-, and 4- tests from the comprehensive battery.Participants were relatively healthy (median CD4 count: 546 cells/mm(3)) with 64% receiving ART. Prevalence of NCI was low (19%). The best 2-test screener included the Stroop Color Test and the Hopkins Verbal Learning Test-Revised (11 min; sensitivity = 73%; specificity = 83%); the best 3-test screener included the above measures plus the Paced Auditory Serial Addition Test (PASAT; 16 min; sensitivity = 86%; specificity = 75%). The addition of Action Fluency to the above three tests improved specificity (18 min; sensitivity = 86%; specificity = 87%).Combinations of widely accepted neuropsychological tests with brief implementation time demonstrated good sensitivity and specificity compared to a time intensive neuropsychological test battery. Tests of verbal learning, attention/working memory, and processing speed are particularly useful in detecting NCI. Utilizing validated, easy to administer, traditional neuropsychological tests with established normative data may represent an excellent approach to screening for NCI in HIV.
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spelling doaj.art-b1cc4c8754814494bbde39e9c5b9a24f2022-12-22T02:02:09ZengPublic Library of Science (PLoS)PLoS ONE1932-62032012-01-01711e4731010.1371/journal.pone.0047310Identification of an abbreviated test battery for detection of HIV-associated neurocognitive impairment in an early-managed HIV-infected cohort.David J MooreMollie J P RoedigerLynn E EberlyKaitlin BlackstoneBraden HaleAmy WeintrobAnuradha GanesanBrian K AganScott L LetendreNancy F Crum-CianfloneHIV-associated neurocognitive disorders (HAND) remain prevalent despite improved antiretroviral treatment (ART), and it is essential to have a sensitive and specific HAND screening tool.Participants were 200 HIV-infected US military beneficiaries, managed early in the course of HIV infection, had few comorbidities, and had open access to ART. Participants completed a comprehensive, seven-domain (16-test), neuropsychological battery (∼120 min); neurocognitive impairment (NCI) was determined using a standardized score derived from demographically adjusted T-scores (global deficit score ≥0.5). Restricting the estimated administration time of the screening battery to < = 20 minutes, we examined the sensitivity and specificity of detecting NCI for all possible combinations of 2-, 3-, and 4- tests from the comprehensive battery.Participants were relatively healthy (median CD4 count: 546 cells/mm(3)) with 64% receiving ART. Prevalence of NCI was low (19%). The best 2-test screener included the Stroop Color Test and the Hopkins Verbal Learning Test-Revised (11 min; sensitivity = 73%; specificity = 83%); the best 3-test screener included the above measures plus the Paced Auditory Serial Addition Test (PASAT; 16 min; sensitivity = 86%; specificity = 75%). The addition of Action Fluency to the above three tests improved specificity (18 min; sensitivity = 86%; specificity = 87%).Combinations of widely accepted neuropsychological tests with brief implementation time demonstrated good sensitivity and specificity compared to a time intensive neuropsychological test battery. Tests of verbal learning, attention/working memory, and processing speed are particularly useful in detecting NCI. Utilizing validated, easy to administer, traditional neuropsychological tests with established normative data may represent an excellent approach to screening for NCI in HIV.http://europepmc.org/articles/PMC3493574?pdf=render
spellingShingle David J Moore
Mollie J P Roediger
Lynn E Eberly
Kaitlin Blackstone
Braden Hale
Amy Weintrob
Anuradha Ganesan
Brian K Agan
Scott L Letendre
Nancy F Crum-Cianflone
Identification of an abbreviated test battery for detection of HIV-associated neurocognitive impairment in an early-managed HIV-infected cohort.
PLoS ONE
title Identification of an abbreviated test battery for detection of HIV-associated neurocognitive impairment in an early-managed HIV-infected cohort.
title_full Identification of an abbreviated test battery for detection of HIV-associated neurocognitive impairment in an early-managed HIV-infected cohort.
title_fullStr Identification of an abbreviated test battery for detection of HIV-associated neurocognitive impairment in an early-managed HIV-infected cohort.
title_full_unstemmed Identification of an abbreviated test battery for detection of HIV-associated neurocognitive impairment in an early-managed HIV-infected cohort.
title_short Identification of an abbreviated test battery for detection of HIV-associated neurocognitive impairment in an early-managed HIV-infected cohort.
title_sort identification of an abbreviated test battery for detection of hiv associated neurocognitive impairment in an early managed hiv infected cohort
url http://europepmc.org/articles/PMC3493574?pdf=render
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