The International HIV Dementia Scale: a new rapid screening test for HIV dementia.
OBJECTIVE
HIV dementia is an important neurological complication of advanced HIV infection. The use of a cross-cultural screening test to detect HIV dementia within the international community is critical for diagnosing this condition. The objective of this study was to evaluate the sensitivity and specificity of a new screening test for HIV dementia, the International HIV Dementia Scale (IHDS) in cohorts from the US and Uganda.


METHODS
Two cross-sectional cohort studies designed to evaluate for the presence of HIV dementia.


METHODS
Sixty-six HIV-positive individuals in the US and 81 HIV-positive individuals in Uganda received the IHDS and full standardized neurological and neuropsychological assessments. The sensitivity and specificity of varying cut-off scores of the IHDS were evaluated in the two cohorts.


RESULTS
In the US cohort, the mean IHDS score for HIV-positive individuals without dementia and with dementia were 10.6 and 9.3 respectively (P < 0.001). Using the cut-off of < or = 10, the sensitivity and specificity for HIV dementia with the IHDS were 80% and 57% respectively in the US cohort, and 80% and 55% respectively in the Uganda cohort.


CONCLUSIONS
The IHDS may be a useful screening test to identify individuals at risk for HIV dementia in both the industrialized world and the developing world. Full neuropsychological testing should then be performed to confirm a diagnosis of HIV dementia.
Sacktor
Ned C
NC
Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland 21224, USA. sacktor@jhmi.edu
Wong
Matthew
M
Nakasujja
Noeline
N
Skolasky
Richard L
RL
Selnes
Ola A
OA
Musisi
Seggane
S
Robertson
Kevin
K
McArthur
Justin C
JC
Ronald
Allan
A
Katabira
Elly
E
D015526:AIDS Dementia Complex / Q000175:diagnosis* / Q000503:physiopathology / Q000523:psychology; D000328:Adult; D000368:Aged; D003431:Cross-Cultural Comparison; D003906:Developing Countries; D006801:Humans; D008403:Mass Screening / Q000379:methods; D011939:Mental Recall; D008875:Middle Aged; D009483:Neuropsychological Tests; D011594:Psychometrics; D011597:Psychomotor Performance; D012680:Sensitivity and Specificity; D014454:Uganda; D014481:United States