Utility of a Short Neuropsychological Protocol for Detecting HIV-Associated Neurocognitive Disorders in Patients with Asymptomatic HIV-1 Infection
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Fecha
2021
Autores
Martinez-Banf, Martha
Vélez, Jorge I.
Mebarak Chams, Moisés R.
Arcos-Holzinger, Mauricio
Acosta-López, Johan E.
García, Ricardo
Perea, María Victoria
Arcos-Burgos, Mauricio
Ladera, Valentina
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MDPI
Resumen
Human Immunodeficiency Virus type 1 (HIV-1) infection is a chronic disease that affects
~40 million people worldwide. HIV-associated neurocognitive disorders (HAND) are common in
individuals with HIV-1 Infection, and represent a recent public health problem. Here we evaluate the
performance of a recently proposed short protocol for detecting HAND by studying 60 individuals
with HIV-1-Infection and 60 seronegative controls from a Caribbean community in Barranquilla,
Colombia. The short evaluation protocol used significant neuropsychological tests from a previous
study of asymptomatic HIV-1 infected patients and a group of seronegative controls. Brief screening
instruments, i.e., the Mini-mental State Examination (MMSE) and the International HIV Dementia
Scale (IHDS), were also applied. Using machine-learning techniques, we derived predictive models
of HAND status, and evaluated their performance with the ROC curves. The proposed short protocol
performs exceptionally well yielding sensitivity, specificity, and overall prediction values >90%, and
better predictive capacity than that of the MMSE and IHDS. Community-specific cut-off values for
HAND diagnosis, based on the MMSE and IHDS, make this protocol suitable for HAND screening in
individuals from this Caribbean community. This study shows the effectivity of a recently proposed
short protocol to detect HAND in individuals with asymptomatic HIV-1-Infection. The application
of community-specific cut-off values for HAND diagnosis in the clinical setting may improve HAND
screening accuracy and facilitate patients’ treatment and follow-up. Further studies are needed to
assess the performance of this protocol in other Latin American populations.
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Palabras clave
HIV, AIDS, HAND, Neurocognitive disorder, Predictive models, Neuropsychological screening, Machine learning
Citación
Martinez-Banfi, M.; Vélez, J.I.; Mebarak Chams, M.R.; Arcos-Holzinger, M.; Acosta-López, J.E.; García, R.; Perea, M.V.; Arcos-Burgos, M.; Ladera, V. Utility of a Short Neuropsychological Protocol for Detecting HIV-Associated Neurocognitive Disorders in Patients with Asymptomatic HIV-1 Infection. Brain Sci. 2021, 11, 1037. https:// doi.org/10.3390/brainsci11081037