Screening for HIV-associated neurocognitive disorders in perinatally infected adolescents: Youth-International HIV dementia scale validation

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dc.contributor.authorPhillips, N.J
dc.contributor.authorThomas, K.G.F
dc.contributor.authorMyer, L
dc.contributor.authorSacktor, N
dc.contributor.authorZar, H.J
dc.contributor.authorStein, D.J
dc.contributor.authorHoare, J
dc.date.accessioned2025-03-02T14:53:10Z
dc.date.available2025-03-02T14:53:10Z
dc.date.issued2019-01-17
dc.description.abstractContext: 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.
dc.description.sponsorshipThe 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.
dc.identifier.citationPhillips NJ, Thomas KGF, Myer L, Sacktor N, Zar HJ, Stein DJ, Hoare J. Screening for HIV-associated neurocognitive disorders in perinatally infected adolescents: youth-International HIV Dementia Scale validation. AIDS. 2019 Apr 1;33(5):815-824. doi: 10.1097/QAD.0000000000002144.
dc.identifier.other10.1097/QAD.0000000000002144
dc.identifier.urihttps://pubmed.ncbi.nlm.nih.gov/30649059/
dc.identifier.urihttps://hdl.handle.net/11288/598188
dc.language.isoen
dc.publisherWolters Kluwer
dc.titleScreening for HIV-associated neurocognitive disorders in perinatally infected adolescents: Youth-International HIV dementia scale validation
dc.typeArticle
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