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HIV-associated neurocognitive disorder in HIV-infected Koreans: The Korean NeuroAIDS Project

 NS Ku  ;  Y Lee  ;  JY Ahn  ;  JE Song  ;  MH Kim  ;  SB Kim  ;  SJ Jeong  ;  K-W Hong  ;  E Kim  ;  SH Han  ;  JY Song  ;  HJ Cheong  ;  YG Song  ;  WJ Kim  ;  JM Kim  ;  DM Smith  ;  JY Choi 
 HIV MEDICINE, Vol.15(8) : 470-477, 2014 
Journal Title
Issue Date
AIDS Dementia Complex/diagnosis* ; AIDS Dementia Complex/epidemiology* ; Adult ; Aged ; Female ; Hospitals, Teaching ; Humans ; Male ; Mass Screening/methods ; Middle Aged ; Neuropsychological Tests* ; Prevalence ; Republic of Korea/epidemiology ; Risk Factors ; Sensitivity and Specificity ; Young Adult
HIV ; HIV-associated neurocognitive disorder (HAND) ; neuropsychological tests ; risk factors ; screening tool
OBJECTIVES: HIV-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.
METHODS: HIV-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.
RESULTS: Among 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 < 0.001) and MoCA-K (P < 0.001) were both useful for screening for HAND. Among NP tests, the sensitivity and specificity of the Grooved Pegboard Test were 90.2 and 72.0%, and those of the Wisconsin Card Sorting Test were 61.2 and 84.4%, respectively.
CONCLUSIONS: HAND is a prevalent comorbidity in HIV-infected Koreans. Active screening and diagnosis with effective tools, such as the IHDS, MoCA-K and Grooved Pegboard Test, could be used to identify this important complication.
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Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Psychiatry (정신과학교실) > 1. Journal Papers
Yonsei Authors
Ku, Nam Su(구남수) ORCID logo https://orcid.org/0000-0002-9717-4327
Kim, Min Hyung(김민형)
Kim, Sun Bean(김선빈)
Kim, Eosu(김어수) ORCID logo https://orcid.org/0000-0001-9472-9465
Kim, June Myung(김준명)
Song, Young Goo(송영구) ORCID logo https://orcid.org/0000-0002-0733-4156
Song, Je Eun(송제은)
Ahn, Jin Young(안진영) ORCID logo https://orcid.org/0000-0002-3740-2826
Lee, Youngjoon(이영준) ORCID logo https://orcid.org/0000-0002-9602-5186
Jeong, Su Jin(정수진) ORCID logo https://orcid.org/0000-0003-4025-4542
Choi, Jun Yong(최준용) ORCID logo https://orcid.org/0000-0002-2775-3315
Han, Sang Hoon(한상훈) ORCID logo https://orcid.org/0000-0002-4278-5198
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