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The International HIV Dementia Scale: a new rapid screening test for HIV dementia

Sacktor, Ned Ca; Wong, Matthewb; Nakasujja, Noelinec; Skolasky, Richard La; Selnes, Ola Aa; Musisi, Segganec; Robertson, Kevind; McArthur, Justin Ca; Ronald, Allane; Katabira, Ellyc

doi: 10.1097/01.aids.0000180790.77379.3a
Basic Science

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.

Design: 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 ≤ 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.

From the aDepartment of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA

bDepartment of Medicine, University of Calgary, Calgary, Alberta, Canada

cDepartment of Medicine, Makerere University, Kampala, Uganda

dDepartment of Neurology, University of North Carolina, Chapel Hill, North Carolina, USA

eDepartment of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.

Received 10 April, 2005

Revised 7 June, 2005

Accepted 27 June, 2005

Correspondence to N. Sacktor, Johns Hopkins Bayview Medical Center, Department of Neurology, B Building, Room 122, 4940 Eastern Avenue, Baltimore, MD 21224, USA. Tel: +1 410 550 0978; fax: +1 410 550 0539; e-mail: sacktor@jhmi.edu

© 2005 Lippincott Williams & Wilkins, Inc.