The International HIV Dementia Scale, a valuable screening instrument for HIV-Associated Neurocognitive Disorder (HAND) in HlV-Infected adults in North Central Nigeria

Abstract

Background: The study sought to determine the usefulness of the International HIV Dementia Scale (IHDS) as a screening tool for HIV-Associated Neurocognitive Disorder (HAND) in HIV-positive adults in Jos. North Central Nigeria. Design: The frequency of HAND is largely unknown in resource-limited settings. In Nigeria, there is paucity of data on the prevalence of HAND because very little research has previously been carried out in this area. We therefore studied 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 in an HIV outpatient clinic were matched to HIV-negative subjects for age, sex and education. Screening for HAND was carried out using IHDS. The study participants were further subjected to full neuropsychological assessment to confirm or exclude HAND Results: Overall, 87 HIV-positive individuals and 87 HIV-negative subjects were screened. The HIV-positive subjects had a significantly lower IHDS mean total score of 8.4±0.2 compared with the HIV-negative subjects with a mean score of 11.1 ±0.7 (p<0.001). Abnormal scores (≤10) on the IHDS were found in 67.8% of the HIV-positive subjects and in 0% of the HIV-negative subjects (p<0.001). Conclusions: The results suggest that the frequency of HAND may be higher than the previous estimates in North Central Nigeria and demonstrates that the IHDS can be used as a screening tool for HAND in Nigeria. We therefore advocate that all studies on HAND in Nigeria should strategically start with the IHDS as a screening tool.