Martinez-Banfi Martha, Vélez Jorge I, Mebarak Chams Moisés R, Arcos-Holzinger Mauricio, Acosta-López Johan E, García Ricardo, Perea María Victoria, Arcos-Burgos Mauricio, Ladera Valentina
Facultad de Ciencias Jurídicas y Sociales, Universidad Simón Bolívar, Barranquilla 080005, Colombia.
Department of Industrial Engineering, Universidad del Norte, Barranquilla 081007, Colombia.
Brain Sci. 2021 Aug 4;11(8):1037. doi: 10.3390/brainsci11081037.
Human Immunodeficiency Virus type 1 (HIV-1) infection is a chronic disease that affects ~40 million people worldwide. HIV-associated neurocognitive disorders (HAND) are common in individuals with HIV-1 Infection, and represent a recent public health problem. Here we evaluate the performance of a recently proposed short protocol for detecting HAND by studying 60 individuals with HIV-1-Infection and 60 seronegative controls from a Caribbean community in Barranquilla, Colombia. The short evaluation protocol used significant neuropsychological tests from a previous study of asymptomatic HIV-1 infected patients and a group of seronegative controls. Brief screening instruments, i.e., the Mini-mental State Examination (MMSE) and the International HIV Dementia Scale (IHDS), were also applied. Using machine-learning techniques, we derived predictive models of HAND status, and evaluated their performance with the ROC curves. The proposed short protocol performs exceptionally well yielding sensitivity, specificity, and overall prediction values >90%, and better predictive capacity than that of the MMSE and IHDS. Community-specific cut-off values for HAND diagnosis, based on the MMSE and IHDS, make this protocol suitable for HAND screening in individuals from this Caribbean community. This study shows the effectivity of a recently proposed short protocol to detect HAND in individuals with asymptomatic HIV-1-Infection. The application of community-specific cut-off values for HAND diagnosis in the clinical setting may improve HAND screening accuracy and facilitate patients' treatment and follow-up. Further studies are needed to assess the performance of this protocol in other Latin American populations.
人类免疫缺陷病毒1型（HIV-1）感染是一种慢性疾病，全球约有4000万人受其影响。HIV相关神经认知障碍（HAND）在HIV-1感染者中很常见，是一个新出现的公共卫生问题。在此，我们通过研究来自哥伦比亚巴兰基亚一个加勒比社区的60名HIV-1感染者和60名血清阴性对照者，评估了最近提出的一种用于检测HAND的简短方案的性能。该简短评估方案采用了先前一项针对无症状HIV-1感染患者及一组血清阴性对照者的研究中的重要神经心理学测试。还应用了简易筛查工具，即简易精神状态检查表（MMSE）和国际HIV痴呆量表（IHDS）。我们使用机器学习技术得出了HAND状态的预测模型，并通过ROC曲线评估了其性能。所提出的简短方案表现出色，灵敏度、特异性和总体预测值均>90%，且预测能力优于MMSE和IHDS。基于MMSE和IHDS得出的针对该社区的HAND诊断临界值，使该方案适用于对这个加勒比社区个体的HAND筛查。本研究显示了最近提出的一种简短方案在检测无症状HIV-1感染者中的HAND方面的有效性。在临床环境中应用针对该社区的HAND诊断临界值可能会提高HAND筛查的准确性，并便于患者的治疗和随访。还需要进一步研究来评估该方案在其他拉丁美洲人群中的性能。
