使用 QPC 认知主诉问卷是否与 HIV 相关神经认知障碍的筛查策略相关？

Is the use of the QPC cognitive complaints questionnaire relevant for the screening strategy of HIV-Associated neurocognitive disorders?

机构信息

Immunohematology Clinical Unit/ HIV Clinical Center, Aix-Marseille University, APHM-Sainte Marguerite Hospital, Marseille, France.

Department of General Medicine, Aix-Marseille University, Marseille, France.

出版信息

AIDS Care. 2021 Mar;33(3):389-397. doi: 10.1080/09540121.2020.1738008. Epub 2020 Apr 11.

DOI:10.1080/09540121.2020.1738008

PMID:32279542

Abstract

BACKGROUND

The screening strategy for HIV-Associated Neurocognitive Disorders (HAND) is challenging. The French Expert Report recommend the use of the Cognitive Complaints Questionnaire (QPC) and the Montreal Cognitive assessment. However, the QPC has never been studied in People Living with HIV (PLWH). This study aims to determine the degree of agreement between QPC and the presence of HAND according to Frascati criteria, established by a battery of neuropsychological tests.

METHODS

Data from patients who performed both a and a battery of neuropsychological tests over a six-month follow-up period were evaluated retrospectively.

RESULTS

A total of 121 patients were selected, with a median age of 53.1 years old. Among participants, 92.6% had an undetectable plasma viral load, 49.6% had a nadir CD4 less than 200/mm and 23.1% had a CDC stage C. Median CD4 cell count was 686/mm. Prevalence of HAND was 57%, including 28.9% of Asymptomatic Neurocognitive Impairment, 24.8% of Mild Neurocognitive Disorder and 3.3% of HIV-associated Dementia. This analyze shows no agreement between and HIV-associated neurocognitive disorders (kappa = -0.007).

CONCLUSIONS

The is not relevant in the screening for HAND. Thus, it urges to develop a specific tool to assess cognitive complaints among PLWH.

摘要

背景

艾滋病相关神经认知障碍（HAND）的筛查策略颇具挑战性。法国专家报告建议使用认知主诉问卷（QPC）和蒙特利尔认知评估。然而，QPC 从未在艾滋病毒感染者（PLWH）中进行过研究。本研究旨在根据神经心理测试组确定的 Frascati 标准，确定 QPC 与 HAND 之间的一致性程度。

方法

回顾性评估了在六个月随访期间同时进行和神经心理测试组的患者的数据。

结果

共选择了 121 名患者，中位年龄为 53.1 岁。参与者中，92.6%的血浆病毒载量无法检测到，49.6%的 CD4 最低点<200/mm，23.1%的 CDC 分期为 C。中位 CD4 细胞计数为 686/mm。HAND 的患病率为 57%，包括无症状神经认知障碍 28.9%、轻度神经认知障碍 24.8%和 HIV 相关痴呆 3.3%。该分析显示和 HIV 相关神经认知障碍之间没有一致性（kappa=−0.007）。