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Title :Comparison of two screening tests for HIV-Associated Neurocognitive Disorder suspected Japanese patients with respect to cART usage
Authors :Kami-Onaga, Kaoru
Tateyama, Masao
Kinjo, Takeshi
Parrott, Gretchen
Tominaga, Daisuke
Takahashi-Nakazato, Ai
Nakamura, Hideta
Tasato, Daisuke
Miyagi, Kyoko
Maeda, Saori
Arae, Hirotaka
Uehara, Hitoshi
Miyagi, Kazuya
Haranaga, Shusaku
Fujita, Jiro
Issue Date :14-Jun-2018
Abstract :In this study, we demonstrated the pervasiveness of HIV-associated neurocognitive disorders (HAND) among a selection of Japanese patients as well as evaluated and comparedthe Mini Mental State Examination (MMSE) and the International HIV Dementia Scale(IHDS) for use as a screening tool among combination anti-retroviral therapy (cART)-naïveand cART experienced patients. The MMSE and the IHDS have both been used as HANDscreening tests around the world with variable success. It has been reported the increasedusage of cART the utility of these screening tests may have been diminished due to thedecreased severity of impairment and the altered pattern of neurocognitive impairments incART era HAND patients. It is therefore possible the MMSE and the IHDS may still be usefulamong cART-naïve patients even in the cART era. However, only one study has investigated and compared the screening results of the IHDS among cART-naïve and cART experienced patients. All HIV positive patients who visited, or were admitted, to the RyukyuUniversity Hospital between January 2009 and March 2014 were evaluated for inclusion.Selected patients (n = 49) had data without omission for all tests. The overall prevalence ofHAND in our cohort was 44%. The area under the curve (AUC), for all subjects using theMMSE and the IHDS, were 0.60 and 0.69, respectively. However, the AUC among cARTnaïve patients were 0.58 and 0.76 for the MMSE and the IHDS, respectively. Whereas,cART experienced patients had an AUC of 0.60 and 0.61, respectively. Overall, the MMSEdemonstrated a poor screening ability for HAND, regardless of cART usage (the cut-offvalue of 27 had a Youden’s J-Index of 0.1, in all groups). Alternatively, the IHDS was moderately useful for HAND screening among cART-naïve patients (the cut-off value of 11 had aYouden’s J-Index of 0.4), but performed poorly as a screening test among cART experienced patients (the cut-off value of 11 had a Youden’s J-Index of 0.1).
URL :https://doi.org/10.1371/journal.pone.0199106
Type Local :雑誌掲載論文
ISSN :1932-6203
Publisher :Public Library of Science
URI :http://hdl.handle.net/20.500.12000/45641
Citation :PLOS ONE Vol.13 no.6
Appears in Collections:Peer-reviewed Journal Articles (Faculty of Medicine)

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