Validity of the International HIV Dementia Scale in Brazil Validade da Escala Internacional de Demência pelo HIV no Brasil

• Main Authors: Roiza Almeida Rodrigues, Raquel Lisboa Oliveira, Beatriz Grinsztejn, Marcus Tulius T. Silva
• Format: Article
• Language: English
• Published: Academia Brasileira de Neurologia (ABNEURO) 2013-06-01
• Series: Arquivos de Neuro-Psiquiatria
• Subjects: Acquired Immunodeficiency Syndrome; HIV; dementia; Síndrome de Imunodeficiência Adquirida; demência
• Online Access: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2013000600376
• ISSN: 0004-282X; 1678-4227

<p id="para1">HIV-associated neurocognitive disorders (HAND) remain prevalent in highly active antiretroviral therapy (HAART) era. Tests to detect HAND are needed for early diagnosis and treatment. Validity of International HIV Dementia Scale (IHDS) has been determined in different countries. The aims of this study were validate IHDS in a Brazilian cohort of HIV-patients and verify if IHDS can be reliably administered by a non-clinician health professional. One hundred and eighty-seven (187) patients were submitted to a full neuropsychological assessment. IHDS was administered twice to each patient (by a non-clinician and by a neurologist). HAND was diagnosed in 98 individuals (68 on HAART). IHDS had sensitivity of 55% and specificity of 80%. IHDS had fair agreement with neuropsychological tests (k 0.355) and moderate-to-strong agreement between different evaluators (interclass correlation coefficient (ICC) 0.684). HAND is prevalent nowadays. IHDS is quick and easy to administer, but has marginal sensitivity for the detection of HIV cognitive impairment other than dementia.</p><br><p id="para2">Dist&#250;rbios neurocognitivos associados ao HIV (HAND) ainda s&#227;o comuns em pacientes usando terapia antirretroviral de alta efic&#225;cia (HAART). Testes diagn&#243;sticos para detec&#231;&#227;o de HAND s&#227;o necess&#225;rios para diagn&#243;stico e terapia precoces. Nossos objetivos foram validar em uma popula&#231;&#227;o brasileira a escala internacional de dem&#234;ncia pelo HIV (IHDS), j&#225; utilizada em outros pa&#237;ses, e avaliar se pode ser confiavelmente aplicada por um profissional n&#227;o m&#233;dico. Avaliamos 187 pacientes com uma extensa bateria neuropsicol&#243;gica. IHDS foi ministrada duas vezes (por m&#233;dico e n&#227;o m&#233;dico). HAND foi diagnosticada em 98 indiv&#237;duos (68 em uso de HAART). A IHDS teve sensibilidade de 55% e especificidade de 80%, com pouca concord&#226;ncia com os testes neuropsicol&#243;gicos (k 0,355) e moderada a forte concord&#226;ncia entre observadores (coeficiente de correla&#231;&#227;o interclasse (ICC) 0,684). HAND ainda &#233; prevalente nos dias atuais. IHDS &#233; um instrumento r&#225;pido e f&#225;cil de ser aplicado, mas com baixa sensibilidade para detec&#231;&#227;o de d&#233;ficit cognitivo outro que n&#227;o dem&#234;ncia.</p>