Utility of the Montreal cognitive assessment and international human immunodeficiency virus dementia scale to screen human immunodeficiency virus-associated neurocognitive disorders among men who have sex with men / 中华传染病杂志

ABSTRACT

Objective:To investigate the efficiency of the Montreal cognitive assessment (MoCA) and international human immunodeficiency virus dementia scale (IHDS) in asymptomatic neurocognitive impairment (ANI) and human immunodeficiency virus-associated dementia (HAD) screening among human immunodeficiency virus (HIV)-infected men who have sex with men (MSM).Methods:According to the exclusion criteria, 210 HIV-infected MSM and 84 HIV-negative MSM were recruited from the First Hospital of China Medical University in Shenyang from December 2016 to December 2018. In this cross-sectional study, the MoCA and IHDS were performed among all HIV-positive and HIV-negative MSM, and their efficiency in ANI and HAD screening were analyzed. Student t-test, one-way analysis of variance and chi-square test were used for statistical analysis. Results:HIV-positive MSM had lower total scores of MoCA and IHDS [(26.04±3.41) and (11.15±1.44)] than HIV-negative controls [(27.58±1.85) and (11.67±0.52)] ( t =-4.970 and -4.542, respectively, both P<0.01). The differences of MoCA and IHDS total scores of HIV-infected patients with different cognitive functions were statistically significant ( F=117.982 and 49.291, respectively, both P<0.05). The proportions of patients with MoCA<26 points and IHDS≤10 points were statistically significant ( χ2=115.917 and 70.155, respectively, both P<0.05). In ANI screening, the cut-off of MoCA<26 points showed a sensitivity of 79% and a specificity of 91%, Youden index was 0.70; and the cut-off of IHDS≤11 points showed a sensitivity of 74% and a specificity of 75% Youden index was 0.49. In HAD screening, the cut-off of MoCA<24 points showed a sensitivity of 88% and a specificity of 87%, Youden index was 0.75; and the cut-off of IHDS≤10 points showed a sensitivity of 68% and a specificity of 87%, Youden index was 0.55. Conclusion:The MoCA is prefered to the IHDS in HIV-associated neurocognitive disorders screening among MSM population, and its cut-off score should be set for the purpose to screen different degrees of cognitive impairment.