TY - JOUR
T1 - Screening for HIV-associated neurocognitive disorders in perinatally infected adolescents
T2 - Youth-International HIV Dementia Scale validation
AU - Phillips, Nicole J.
AU - Thomas, Kevin G.F.
AU - Myer, Landon
AU - Sacktor, Ned
AU - Zar, Heather J.
AU - Stein, Dan J.
AU - Hoare, Jacqueline
N1 - Funding Information:
The research was supported by Eunice Kennedy Shriver National Institute of Child Health and Human Development under grant R01HD074501. N.J.P. receives funding from the South African Medical Research Council (SAMRC) in terms of the National Health Scholarships Programme (NHSP) towards her PhD studies. All authors have no financial relationships relevant to this article to disclose.
Funding Information:
Contributor's statements: N.J.P. developed the concept for the article, was responsible for overseeing data collection and quality control thereof, conducting the ground work and final statistical analysis. She is responsible for the write-up of the final article and for submission to the journal, and she approved the final article as submitted. N.J.P. will also be the corresponding author for this article and will address any reviewer comments received. N.J.P. receives funding from the South African Medical Research Council in terms of the National Health Scholarships Programme towards her PhD studies for 2015–2017.
Publisher Copyright:
© 2019 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2019/4/1
Y1 - 2019/4/1
N2 - Context:Perinatal HIV infection has adverse cognitive consequences into adolescence. However, there are no screening tools that assess risk for HIV-associated neurocognitive disorders in adolescent populations. Such screening tools are needed urgently for clinical care in resource-poor settings with a high prevalence of HIV.Objective:To investigate the performance of the International HIV Dementia Scale (IHDS) as a screening tool for HIV-associated neurocognitive disorders in perinatally adolescents.Design:The current study is a quantitative, quasiexperimental design.Methods:Perinatally HIV-infected adolescents aged 9-12 years were recruited from community health clinics into the Cape Town Adolescent Antiretroviral Cohort; matched HIV-negative controls from the same communities were enrolled. Each participant completed the IHDS and a comprehensive neuropsychological battery. The adult version of the IHDS was performed, except for two minor modifications. We evaluated the diagnostic validity of this modified instrument, the youth-IHDS (y-IHDS), using a four-step process that included sensitivity and specificity calculations, and generating receiver operating characteristic curves. Validity was measured against the youth HIV-associated diagnostic criteria.Results:At a cut-off score of 10 or less, the y-IHDS demonstrated good sensitivity (94%) but poor specificity (24%) for detecting all forms of neurocognitive disorders, with an acceptable area under the curve value of 0.695.Conclusion:The y-IHDS requires minimal resources and is based on a screening tool for adult HIV-associated cognitive disorders that is already widely used globally. Hence, this brief, cost-efficient, and valid screening tool may be a useful addition for clinicians working in resource-poor contexts in which adolescent HIV is highly prevalent.
AB - Context:Perinatal HIV infection has adverse cognitive consequences into adolescence. However, there are no screening tools that assess risk for HIV-associated neurocognitive disorders in adolescent populations. Such screening tools are needed urgently for clinical care in resource-poor settings with a high prevalence of HIV.Objective:To investigate the performance of the International HIV Dementia Scale (IHDS) as a screening tool for HIV-associated neurocognitive disorders in perinatally adolescents.Design:The current study is a quantitative, quasiexperimental design.Methods:Perinatally HIV-infected adolescents aged 9-12 years were recruited from community health clinics into the Cape Town Adolescent Antiretroviral Cohort; matched HIV-negative controls from the same communities were enrolled. Each participant completed the IHDS and a comprehensive neuropsychological battery. The adult version of the IHDS was performed, except for two minor modifications. We evaluated the diagnostic validity of this modified instrument, the youth-IHDS (y-IHDS), using a four-step process that included sensitivity and specificity calculations, and generating receiver operating characteristic curves. Validity was measured against the youth HIV-associated diagnostic criteria.Results:At a cut-off score of 10 or less, the y-IHDS demonstrated good sensitivity (94%) but poor specificity (24%) for detecting all forms of neurocognitive disorders, with an acceptable area under the curve value of 0.695.Conclusion:The y-IHDS requires minimal resources and is based on a screening tool for adult HIV-associated cognitive disorders that is already widely used globally. Hence, this brief, cost-efficient, and valid screening tool may be a useful addition for clinicians working in resource-poor contexts in which adolescent HIV is highly prevalent.
KW - HIV-associated neurocognitive disorders
KW - International HIV Dementia Scale
KW - children and adolescents
KW - perinatally HIV infected
KW - scale validation
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U2 - 10.1097/QAD.0000000000002144
DO - 10.1097/QAD.0000000000002144
M3 - Article
C2 - 30649059
AN - SCOPUS:85061879424
SN - 0269-9370
VL - 33
SP - 815
EP - 824
JO - AIDS
JF - AIDS
IS - 5
ER -