The International HIV Dementia Scale Is a Useful Screening Tool for HIV-Associated Dementia/Cognitive Impairment in HIV-Infected Adults in Yaoundé-Cameroon

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Abstract

Objective:

As a baseline for a series of studies on HIV-associated dementia (HAD), we sought to assess the usefulness of the recently developed International HIV Dementia Scale (IHDS) as a screening tool for HAD or HIV-associated cognitive impairment (HACI) in HIV-positive adults in Yaoundé-Cameroon.

Design:

The frequency of HAD/HACI is largely unknown in resource-limited countries. In Cameroon, few studies suggest that HAD may be frequent but no specific study had so far investigated the problem. We therefore used a case-control study design involving HIV-positive adults as cases and HIV-negative individuals as controls to determine the usefulness of the IHDS as a screening instrument.

Methods:

HIV-positive adults followed up in an HIV outpatient clinic were matched to HIV-negative subjects for age and sex and screened using IHDS.

Results:

Overall, 204 HIV-positive individuals and 204 HIV-negative subjects were screened. The HIV-positive subjects had a significantly lower IHDS mean total score of 10.87 compared with the HIV-negative subjects with a score of 11.28 (P = 0.00). Abnormal scores (≤10) on the IHDS were found in 21.1% of the HIV-positive subjects and in 2.5% of the HIV-negative subjects (P = 5.0 × 10−10).

Conclusions:

These results suggest that the prevalence of possible HAD/HACI may be higher in Cameroon than the previous estimates and demonstrate that the IHDS can be used as a screening tool for HAD in Cameroon. We therefore suggest that all studies on HAD in Cameroon should strategically start with the IHDS as a screening tool.

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