In the Journals

Mild HIV-related cognitive impairments overlooked

Milder forms of HIV-associated neurocognitive disorders, or HANDs, are overlooked by modern screening tools, according to the results of a recent literature review.

"Identifying that patients have a mild form of this condition is critical," study researcher Sean B. Rourke, PhD, a neuropsychologist who heads the neurobehavioral research unit at St. Michael's Hospital in Toronto, said in a press release. "Even mild neurocognitive problems can have a significant impact on a person's everyday functioning, affecting his or her ability to take medications or ability to perform at work, and may also lead to more social isolation and withdrawal."

Sean B. Rourke, PhD 

Sean B. Rourke

Rourke and colleagues reviewed 31 studies that examined the utility of brief screening tools used to detect HANDs in adult patients with HIV. Thirty-nine screening tools were included in the analyses, and 67% of the studies used a comprehensive neuropsychological battery as a reference. Thirty-five percent of the studies focused on detecting HIV-associated dementia (HAD), the most severe form of HAND.

Meta-analyses indicated that the most commonly used screening tool, the HIV Dementia Scale (HDS), and the HDS version adapted for use in global settings, IHDS, performed well when screening for HAD, but were unreliable in detecting milder HAND conditions.

According to the researchers, 20% to 25% of the adult HIV population is affected by mild neurocognitive disorder (MND).

Rourke told Infectious Disease News that there are currently no validated neurocognitive screening tools that are recommended for identifying milder HAND conditions such as asymptomatic neuropsychological impairment (ANI) or MND.

"Formal neuropsychological examinations are recommended if a patient is suspected of having a milder form of HAND (e.g., ANI or MND)," he said.

Sean B. Rourke, PhD, can be reached at sean.rourke@utoronto.ca.

Disclosure: Rourke reports no relevant financial disclosures.

Milder forms of HIV-associated neurocognitive disorders, or HANDs, are overlooked by modern screening tools, according to the results of a recent literature review.

"Identifying that patients have a mild form of this condition is critical," study researcher Sean B. Rourke, PhD, a neuropsychologist who heads the neurobehavioral research unit at St. Michael's Hospital in Toronto, said in a press release. "Even mild neurocognitive problems can have a significant impact on a person's everyday functioning, affecting his or her ability to take medications or ability to perform at work, and may also lead to more social isolation and withdrawal."

Sean B. Rourke, PhD 

Sean B. Rourke

Rourke and colleagues reviewed 31 studies that examined the utility of brief screening tools used to detect HANDs in adult patients with HIV. Thirty-nine screening tools were included in the analyses, and 67% of the studies used a comprehensive neuropsychological battery as a reference. Thirty-five percent of the studies focused on detecting HIV-associated dementia (HAD), the most severe form of HAND.

Meta-analyses indicated that the most commonly used screening tool, the HIV Dementia Scale (HDS), and the HDS version adapted for use in global settings, IHDS, performed well when screening for HAD, but were unreliable in detecting milder HAND conditions.

According to the researchers, 20% to 25% of the adult HIV population is affected by mild neurocognitive disorder (MND).

Rourke told Infectious Disease News that there are currently no validated neurocognitive screening tools that are recommended for identifying milder HAND conditions such as asymptomatic neuropsychological impairment (ANI) or MND.

"Formal neuropsychological examinations are recommended if a patient is suspected of having a milder form of HAND (e.g., ANI or MND)," he said.

Sean B. Rourke, PhD, can be reached at sean.rourke@utoronto.ca.

Disclosure: Rourke reports no relevant financial disclosures.