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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
 HIV Medicine 
Issue Date
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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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
구남수(Ku, Nam Su) ORCID logo https://orcid.org/0000-0002-9717-4327
김민형(Kim, Min Hyung)
김선빈(Kim, Sun Bean)
김어수(Kim, Eosu) ORCID logo https://orcid.org/0000-0001-9472-9465
김준명(Kim, June Myung)
송영구(Song, Young Goo) ORCID logo https://orcid.org/0000-0002-0733-4156
송제은(Song, Je Eun)
안진영(Ahn, Jin Young) ORCID logo https://orcid.org/0000-0002-3740-2826
이영준(Lee, Youngjoon) ORCID logo https://orcid.org/0000-0002-9602-5186
정수진(Jeong, Su Jin) ORCID logo https://orcid.org/0000-0003-4025-4542
최준용(Choi, Jun Yong) ORCID logo https://orcid.org/0000-0002-2775-3315
한상훈(Han, Sang Hoon) ORCID logo https://orcid.org/0000-0002-4278-5198
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