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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Validity of the international HIV dementia scale in South Africa
AIDS Patient Care and STDs, Volume 25, No. 2, Year 2011
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Description
HIV-associated neurocognitive disorders (HAND) remain prevalent, especially in regions like South Africa where HIV prevalence is high but access to antiretroviral treatment (ART) is limited. The incidence of HIV dementia (HAD) has been halved with the use of ART, but the prevalence remains high. Appropriate brief screening tools to screen for HAD are needed in order to facilitate treatment initiation. The validity of the International HIV Dementia Scale has not been established in a region where infection with HIV clade C is predominant. The International HIV Dementia Scale (IHDS) was administered together with a detailed neuropsychological test battery to 96 HIV-positive individuals who had not received ART and who were attending primary care HIV clinics. The validity of the IHDS was established using a receiver operating characteristic (ROC) analysis. HIV-positive individuals displayed greater impairment when compared to HIV-negative controls on the IHDS and a range of neuropsychological tests. Neuropsychological tests discriminated well across HAND categories for HIV-positive individuals. In ROC analysis, the IHDS showed an area under the curve of 0.64, with a sensitivity of 45% and specificity of 79% at a cutoff score of 10. Individuals with HAD, who screened negative on the IHDS, performed poorly on some tests of executive function. These data suggest that the IHDS may have limitations as a tool to screen for HAD in South Africans infected with HIV. Variable performance in neuropsychological testing may account for false negative screens. The inclusion of brief tests of executive function in a screening battery should be considered. © Copyright 2011, Mary Ann Liebert, Inc.
Authors & Co-Authors
Joska, John A.
South Africa, Observatory
Groote Schuur Hospital
Westgarth-Taylor, Jennifer
South Africa, Observatory
Groote Schuur Hospital
South Africa, Cape Town
University of Cape Town
Hoare, Jacqueline
South Africa, Observatory
Groote Schuur Hospital
Thomas, Kevin G.F. Garth Flusk
South Africa, Cape Town
University of Cape Town
Paul, Robert H.
United States, St. Louis
University of Missouri-st. Louis
Myer, Landon
South Africa, Cape Town
University of Cape Town
United States, New York
Columbia University
Stein, Dan J.
South Africa, Observatory
Groote Schuur Hospital
Statistics
Citations: 77
Authors: 7
Affiliations: 4
Identifiers
Doi:
10.1089/apc.2010.0292
ISSN:
10872914
Research Areas
Health System And Policy
Infectious Diseases
Mental Health
Study Design
Cross Sectional Study
Cohort Study
Study Locations
South Africa