Applying the HIV-associated neurocognitive disorder diagnostic criteria to HIV-infected youth
Applying the HIV-associated neurocognitive disorder diagnostic criteria to HIV-infected youth
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DOI：
10.1212/wnl.0000000000002669
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发表时间：
2016-07-05
期刊：
影响因子：
9.9
通讯作者：
Thomas, Kevin G. F.
中科院分区：
文献类型：
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作者：
Hoare, Jacqueline;Phillips, Nicole;Thomas, Kevin G. F.
目的：本研究的目的是应用 HIV 相关神经认知障碍 (HAND) 标准在 HIV 感染成年人和 HIV 感染青少年队列中诊断 HAND，从而确定该系统是否能够检测 HIV 感染青少年中的一系列神经认知障碍 (ND)。 方法：我们使用综合儿童神经认知电池、功能能力评估以及美国神经病学学会系统来诊断儿童中的 ND。对 HIV 感染青少年 (n = 86) 和 HIV 阴性对照 (n = 34) 进行横断面研究，以确定该系统是否可以检测 HIV 感染青少年（6-16 岁）的一系列 ND。 结果：与 HIV 阴性青少年的匹配对照组相比，HIV 感染青少年在言语智商、全面智商、处理速度、手指敲击、语言记忆、表达性语言、认知灵活性、和抑制。感染艾滋病毒的青少年也更有可能在儿童行为检查表上的总体能力受损。使用 HAND 标准，我们发现 86 名 HIV 感染青少年中有 45.35% 可以诊断为 ND。此外，与未感染 HIV 脑病 (HIVE) 的青少年相比，感染 HIV 的青少年诊断出严重 ND 的可能性高出 9.4 倍。结论：专为成人设计的 HAND 标准能够识别出患有重要功能性认知障碍的青少年，这些患者不符合 HIVE 标准，因此无法通过其他方式进行识别。这对于管理感染艾滋病毒的青少年的重要性具有重大的临床意义。
Objective:The aim of this study was to apply the HIV-associated neurocognitive disorders (HAND) criteria for diagnosing HAND in HIV-infected adults, in a cohort of HIV-infected youth to thus establish whether this system is able to detect a spectrum of neurocognitive disorders (ND) in HIV-infected youth.Methods:We used a comprehensive pediatric neurocognitive battery, an assessment of functional competence, and the American Academy of Neurology system for diagnosing ND in a cross-sectional study of HIV-infected youth (n = 86) and HIV-negative controls (n = 34) to establish whether this system could detect a spectrum of ND in HIV-infected youth (6-16 years).Results:Compared to a well-matched control group of HIV-negative youth, HIV-infected youth performed significantly more poorly on tests of Verbal IQ, Full Scale IQ, processing speed, finger tapping, verbal memory, expressive language, cognitive flexibility, and inhibition. HIV-infected youth were also more likely to have impaired total competence on the Child Behavior Checklist. Using the criteria for HAND, we found that 45.35% of the 86 HIV-infected youth could be diagnosed with an ND. Furthermore, youth with HIV encephalopathy (HIVE) were 9.4 times more likely to have a diagnosis of a major ND compared to HIV-infected youth without HIVE.Conclusions:The HAND criterion designed for adults was able to identify youth with important functional cognitive impairments who do not fit criteria for HIVE and would therefore not have been identified otherwise. This has major clinical implications regarding the importance of managing HIV-infected youth.