Utility of a Short Neuropsychological Protocol for Detecting HIV-Associated Neurocognitive Disorders in Patients with Asymptomatic HIV-1 Infection

Abstract

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.

Fewer neurocognitive deficits and less brain atrophy by third ventricle measurement in PLWH treated with modern ART: A prospective analysis

“…Alternative scales such as the HIV dementia scale, Western Neuropsychological Test Battery ( 39 ), or the international HIV dementia scale ( 40 ), which were used to identify HAD patients, might need to be reassessed during the period of adequate ART therapy ( 12 ) or the establishment of new cut-off values ( 41 ).…”

Exosomes: Potential Disease Biomarkers and New Therapeutic Targets

“…Currently, our research group studies the differential expression of ncRNA in subjects with Alzheimer's disease compared to healthy subjects. We also plan to study the exosomal load in patients with attention deficit-hyperactivity disorder [359][360][361][362][363][364] and HIV and Huntington's disease [365,366]. Funding: This study was financed by MINCIENCIAS, project "Nuevos ARN no codificantes exosomales y su papel en la patogénesis de la Enfermedad de Alzheimer", code 121584468097, grant 844/2019, contract 416-2020, awarded to Grupo en Genética y Medicina Molecular and Grupo de Productividad y Competitividad, Universidad del Norte, Barranquilla, Colombia.…”