title: Classification models for neurocognitive impairment in HIV infection based on demographic and clinical variables.
abstract: OBJECTIVE
  We used demographic and clinical data to design practical classification models for prediction of neurocognitive impairment (NCI) in people with HIV infection.
  
  
  METHODS
  The study population comprised 331 HIV-infected patients with available demographic, clinical, and neurocognitive data collected using a comprehensive battery of neuropsychological tests. Classification and regression trees (CART) were developed to obtain detailed and reliable models to predict NCI. Following a practical clinical approach, NCI was considered the main variable for study outcomes, and analyses were performed separately in treatment-naïve and treatment-experienced patients.
  
  
  RESULTS
  The study sample comprised 52 treatment-naïve and 279 experienced patients. In the first group, the variables identified as better predictors of NCI were CD4 cell count and age (correct classification [CC]: 79.6%, 3 final nodes). In treatment-experienced patients, the variables most closely related to NCI were years of education, nadir CD4 cell count, central nervous system penetration-effectiveness score, age, employment status, and confounding comorbidities (CC: 82.1%, 7 final nodes). In patients with an undetectable viral load and no comorbidities, we obtained a fairly accurate model in which the main variables were nadir CD4 cell count, current CD4 cell count, time on current treatment, and past highest viral load (CC: 88%, 6 final nodes).
  
  
  CONCLUSIONS
  Practical classification models to predict NCI in HIV infection can be obtained using demographic and clinical variables. An approach based on CART analyses may facilitate screening for HIV-associated neurocognitive disorders and complement clinical information about risk and protective factors for NCI in HIV-infected patients.
authors.affiliation: Fundació Lluita contra la SIDA - Hospital Universitari Germans Trias i Pujol, Badalona, Catalonia, Spain; Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Catalonia, Spain.
authors.forename: Jose A
authors.initials: JA
authors.lastname: Muñoz-Moreno
authors.affiliation: Fundació Lluita contra la SIDA - Hospital Universitari Germans Trias i Pujol, Badalona, Catalonia, Spain; Universitat Politècnica de Catalunya, Barcelona, Catalonia, Spain.
authors.forename: Núria
authors.initials: N
authors.lastname: Pérez-Álvarez
authors.affiliation: Universitat de Barcelona, Barcelona, Catalonia, Spain.
authors.forename: Amalia
authors.initials: A
authors.lastname: Muñoz-Murillo
authors.affiliation: Fundació Lluita contra la SIDA - Hospital Universitari Germans Trias i Pujol, Badalona, Catalonia, Spain; Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Catalonia, Spain.
authors.forename: Anna
authors.initials: A
authors.lastname: Prats
authors.affiliation: Consorci Sanitari Hospital de Terrassa, Terrassa, Catalonia, Spain; Grup de Recerca Consolidat de Neuropsicologia - Universitat de Barcelona, Barcelona, Catalonia, Spain.
authors.forename: Maite
authors.initials: M
authors.lastname: Garolera
authors.affiliation: Universitat de Barcelona, Barcelona, Catalonia, Spain; Grup de Recerca Consolidat de Neuropsicologia - Universitat de Barcelona, Barcelona, Catalonia, Spain.
authors.forename: M Àngels
authors.initials: MÀ
authors.lastname: Jurado
authors.affiliation: Fundació Lluita contra la SIDA - Hospital Universitari Germans Trias i Pujol, Badalona, Catalonia, Spain; Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Catalonia, Spain.
authors.forename: Carmina R
authors.initials: CR
authors.lastname: Fumaz
authors.affiliation: Fundació Lluita contra la SIDA - Hospital Universitari Germans Trias i Pujol, Badalona, Catalonia, Spain; Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Catalonia, Spain.
authors.forename: Eugènia
authors.initials: E
authors.lastname: Negredo
authors.affiliation: Fundació Lluita contra la SIDA - Hospital Universitari Germans Trias i Pujol, Badalona, Catalonia, Spain; Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Catalonia, Spain.
authors.forename: Maria J
authors.initials: MJ
authors.lastname: Ferrer
authors.affiliation: Fundació Lluita contra la SIDA - Hospital Universitari Germans Trias i Pujol, Badalona, Catalonia, Spain; Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Catalonia, Spain; Institut de Recerca per la SIDA IrsiCaixa, Badalona, Catalonia, Spain; Universitat de Vic, Vic, Catalonia, Spain.
authors.forename: Bonaventura
authors.initials: B
authors.lastname: Clotet
mesh_terms: D000328:Adult; D003072:Cognition Disorders / Q000145:classification* / Q000150:complications; D003710:Demography; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D008297:Male; D013030:Spain