Applying the HIV-associated neurocognitive disorder diagnostic criteria to HIV-infected youth
Identifieur interne : 000311 ( Pmc/Corpus ); précédent : 000310; suivant : 000312Applying the HIV-associated neurocognitive disorder diagnostic criteria to HIV-infected youth
Auteurs : Jacqueline Hoare ; Nicole Phillips ; John A. Joska ; Robert Paul ; Kirsten A. Donald ; Dan J. Stein ; Kevin G. F. ThomasSource :
- Neurology [ 0028-3878 ] ; 2016.
Abstract
The aim of this study was to apply the HIV-associated neurocognitive disorders (HAND) criteria for diagnosing HAND in HIV-infected adults, in a cohort of HIV-infected youth to thus establish whether this system is able to detect a spectrum of neurocognitive disorders (ND) in HIV-infected youth.
We used a comprehensive pediatric neurocognitive battery, an assessment of functional competence, and the American Academy of Neurology system for diagnosing ND in a cross-sectional study of HIV-infected youth (n = 86) and HIV-negative controls (n = 34) to establish whether this system could detect a spectrum of ND in HIV-infected youth (6–16 years).
Compared to a well-matched control group of HIV-negative youth, HIV-infected youth performed significantly more poorly on tests of Verbal IQ, Full Scale IQ, processing speed, finger tapping, verbal memory, expressive language, cognitive flexibility, and inhibition. HIV-infected youth were also more likely to have impaired total competence on the Child Behavior Checklist. Using the criteria for HAND, we found that 45.35% of the 86 HIV-infected youth could be diagnosed with an ND. Furthermore, youth with HIV encephalopathy (HIVE) were 9.4 times more likely to have a diagnosis of a major ND compared to HIV-infected youth without HIVE.
The HAND criterion designed for adults was able to identify youth with important functional cognitive impairments who do not fit criteria for HIVE and would therefore not have been identified otherwise. This has major clinical implications regarding the importance of managing HIV-infected youth.
Url:
DOI: 10.1212/WNL.0000000000002669
PubMed: 27206720
PubMed Central: 4932240
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PMC:4932240Le document en format XML
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<author><name sortKey="Hoare, Jacqueline" sort="Hoare, Jacqueline" uniqKey="Hoare J" first="Jacqueline" last="Hoare">Jacqueline Hoare</name>
</author>
<author><name sortKey="Phillips, Nicole" sort="Phillips, Nicole" uniqKey="Phillips N" first="Nicole" last="Phillips">Nicole Phillips</name>
</author>
<author><name sortKey="Joska, John A" sort="Joska, John A" uniqKey="Joska J" first="John A." last="Joska">John A. Joska</name>
</author>
<author><name sortKey="Paul, Robert" sort="Paul, Robert" uniqKey="Paul R" first="Robert" last="Paul">Robert Paul</name>
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<author><name sortKey="Donald, Kirsten A" sort="Donald, Kirsten A" uniqKey="Donald K" first="Kirsten A." last="Donald">Kirsten A. Donald</name>
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<author><name sortKey="Stein, Dan J" sort="Stein, Dan J" uniqKey="Stein D" first="Dan J." last="Stein">Dan J. Stein</name>
</author>
<author><name sortKey="Thomas, Kevin G F" sort="Thomas, Kevin G F" uniqKey="Thomas K" first="Kevin G. F." last="Thomas">Kevin G. F. Thomas</name>
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Applying the HIV-associated neurocognitive disorder diagnostic criteria to HIV-infected youth</title>
<author><name sortKey="Hoare, Jacqueline" sort="Hoare, Jacqueline" uniqKey="Hoare J" first="Jacqueline" last="Hoare">Jacqueline Hoare</name>
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<author><name sortKey="Phillips, Nicole" sort="Phillips, Nicole" uniqKey="Phillips N" first="Nicole" last="Phillips">Nicole Phillips</name>
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<author><name sortKey="Joska, John A" sort="Joska, John A" uniqKey="Joska J" first="John A." last="Joska">John A. Joska</name>
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<author><name sortKey="Paul, Robert" sort="Paul, Robert" uniqKey="Paul R" first="Robert" last="Paul">Robert Paul</name>
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<author><name sortKey="Donald, Kirsten A" sort="Donald, Kirsten A" uniqKey="Donald K" first="Kirsten A." last="Donald">Kirsten A. Donald</name>
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<author><name sortKey="Stein, Dan J" sort="Stein, Dan J" uniqKey="Stein D" first="Dan J." last="Stein">Dan J. Stein</name>
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<author><name sortKey="Thomas, Kevin G F" sort="Thomas, Kevin G F" uniqKey="Thomas K" first="Kevin G. F." last="Thomas">Kevin G. F. Thomas</name>
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<series><title level="j">Neurology</title>
<idno type="ISSN">0028-3878</idno>
<idno type="eISSN">1526-632X</idno>
<imprint><date when="2016">2016</date>
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<front><div type="abstract" xml:lang="en"><sec><title>Objective:</title>
<p>The aim of this study was to apply the HIV-associated neurocognitive disorders (HAND) criteria for diagnosing HAND in HIV-infected adults, in a cohort of HIV-infected youth to thus establish whether this system is able to detect a spectrum of neurocognitive disorders (ND) in HIV-infected youth.</p>
</sec>
<sec><title>Methods:</title>
<p>We used a comprehensive pediatric neurocognitive battery, an assessment of functional competence, and the American Academy of Neurology system for diagnosing ND in a cross-sectional study of HIV-infected youth (n = 86) and HIV-negative controls (n = 34) to establish whether this system could detect a spectrum of ND in HIV-infected youth (6–16 years).</p>
</sec>
<sec><title>Results:</title>
<p>Compared to a well-matched control group of HIV-negative youth, HIV-infected youth performed significantly more poorly on tests of Verbal IQ, Full Scale IQ, processing speed, finger tapping, verbal memory, expressive language, cognitive flexibility, and inhibition. HIV-infected youth were also more likely to have impaired total competence on the Child Behavior Checklist. Using the criteria for HAND, we found that 45.35% of the 86 HIV-infected youth could be diagnosed with an ND. Furthermore, youth with HIV encephalopathy (HIVE) were 9.4 times more likely to have a diagnosis of a major ND compared to HIV-infected youth without HIVE.</p>
</sec>
<sec><title>Conclusions:</title>
<p>The HAND criterion designed for adults was able to identify youth with important functional cognitive impairments who do not fit criteria for HIVE and would therefore not have been identified otherwise. This has major clinical implications regarding the importance of managing HIV-infected youth.</p>
</sec>
</div>
</front>
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<pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Neurology</journal-id>
<journal-id journal-id-type="iso-abbrev">Neurology</journal-id>
<journal-id journal-id-type="hwp">neurology</journal-id>
<journal-id journal-id-type="publisher-id">neur</journal-id>
<journal-id journal-id-type="pmc">neurology</journal-id>
<journal-id journal-id-type="publisher-id">NEUROLOGY</journal-id>
<journal-title-group><journal-title>Neurology</journal-title>
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<issn pub-type="ppub">0028-3878</issn>
<issn pub-type="epub">1526-632X</issn>
<publisher><publisher-name>Lippincott Williams & Wilkins</publisher-name>
<publisher-loc>Hagerstown, MD</publisher-loc>
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<article-id pub-id-type="pmc">4932240</article-id>
<article-id pub-id-type="publisher-id">NEUROLOGY2015684415</article-id>
<article-id pub-id-type="doi">10.1212/WNL.0000000000002669</article-id>
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<title-group><article-title>Applying the HIV-associated neurocognitive disorder diagnostic criteria to HIV-infected youth</article-title>
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<contrib-group><contrib contrib-type="author" corresp="yes"><name><surname>Hoare</surname>
<given-names>Jacqueline</given-names>
</name>
<degrees>FCPsych, Mphil</degrees>
<author-comment content-type="disclosure"><p><list list-type="order"><title>Scientific Advisory Boards:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Gifts:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Funding for Travel or Speaker Honoraria:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Editorial Boards:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Patents:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Publishing Royalties:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Employment, Commercial Entity:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Consultancies:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Speakers' Bureaus:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Other Activities:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Clinical Procedures or Imaging Studies:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Research Support, Commercial Entities:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Research Support, Government Entities:</title>
<list-item><p>The funds below did not fund the study in the paper NIH R21: 1R21AI116309-01 J Hoare (PI) and D Operatio (PI) 2015-2017 NIH R01: 1R01HD074051-01 H Zar (PI) 2012-2017 Cape Town Adolescent Antiretroviral Cohort (CTAAC). Role: Co-investigator (lead of Neuro-substudy)</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Research Support, Academic Entities:</title>
<list-item><p>SIR MRC Grant (2014-2016), NRC Thuthuka grant and the Harry Crossley grant funded the current study A Diffusion Tensor Imaging and Neurocognitive Study of ART-na?ve and ART- treated Children in Cape Town Role: Principal Investigator</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Research Support, Foundations and Societies:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Stock/Stock Options/Board of Directors Compensation:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>License Fee Payments, Technology or Inventions:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Royalty Payments, Technology or Inventions:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Stock/Stock Options, Research Sponsor:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Stock/Stock Options, Medical Equipment & Materials:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Legal Proceedings:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
</author-comment>
</contrib>
<contrib contrib-type="author"><name><surname>Phillips</surname>
<given-names>Nicole</given-names>
</name>
<degrees>BAHons</degrees>
<author-comment content-type="disclosure"><p><list list-type="order"><title>Scientific Advisory Boards:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Gifts:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Funding for Travel or Speaker Honoraria:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Editorial Boards:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Patents:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Publishing Royalties:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Employment, Commercial Entity:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Consultancies:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Speakers' Bureaus:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Other Activities:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Clinical Procedures or Imaging Studies:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Research Support, Commercial Entities:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Research Support, Government Entities:</title>
<list-item><p>Receiving funding towards my PhD studies from the South African Medical Research Council (2015 - present). This funding is not associated with the current project as submitted to Neurology Journal, and in way influenced the findings in the paper.</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Research Support, Academic Entities:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Research Support, Foundations and Societies:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Stock/Stock Options/Board of Directors Compensation:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>License Fee Payments, Technology or Inventions:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Royalty Payments, Technology or Inventions:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Stock/Stock Options, Research Sponsor:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Stock/Stock Options, Medical Equipment & Materials:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Legal Proceedings:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
</author-comment>
</contrib>
<contrib contrib-type="author"><name><surname>Joska</surname>
<given-names>John A.</given-names>
</name>
<degrees>FCPsych, PhD</degrees>
<author-comment content-type="disclosure"><p><list list-type="order"><title>Scientific Advisory Boards:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Gifts:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Funding for Travel or Speaker Honoraria:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Editorial Boards:</title>
<list-item><p>Aids and Behavior, editorial board, current</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Patents:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Publishing Royalties:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Employment, Commercial Entity:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Consultancies:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Speakers' Bureaus:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Other Activities:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Clinical Procedures or Imaging Studies:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Research Support, Commercial Entities:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Research Support, Government Entities:</title>
<list-item><p>1. NIMH R01MH103770-01: Steven Safren (P.I.); funded 2015-2019. ?Effectiveness of nurse-delivered care for adherence/mood in HIV in South Africa?. This study aims to investigate whether nurses can deliver a CBT intervention in primary health care. Role- co P.I. 2. NIMH R34MH102001-01A1; Kathleen Sikkema (P.I.); funded 2014 to 2017- ?Improving the Health of South African Women with Traumatic Stress in HIV care?: This study aims to adapt an intervention for women with a history of sexual trauma entering HIV care, by measuring health- related and mental health outcomes. Role: Co-P.I. 3. NICHD R01 HD074051; Heather Zar (P.I.); funded 2012-2017- ?Cape Town Adolescent Antiretroviral Cohort (CTAAC)?: This cohort study capitalizes on an existing infrastructure to recruit HIV-infected adolescents over a 3-year period to conduct multi-system assessments. The impact of neurologic disease on adolescent brain development and psychosocial outcomes is the focus of the sub-aim. Role: Co-investigator 4. NIMH RO1 MH095576-01; Robert Remien (P.I.) ; 01 August 2011- 31 July 2016 ; Description : Masivukeni: A Multimedia ART Adherence Intervention for Resource-Limited SettingsThe aim of this study is to refine a multi-media intervention designed to deliver information regarding HIV treatment readiness to patients initiating anti-retroviral treatment; and to compare its effectiveness against standard of care in a randomised controlled trial. Role: Co- P.I. 5. EDCTP-DST Strategic Primer grant: ?A randomised controlled trial of lithium carbonate in individuals with hiv clade c-associated neurocognitive impairment.? Role: PI. 6. CFAR- Duke University: ?Sero-prevalence of HIV among methamphetamine treatment seekers in Cape Town?. Role: PI.</p>
</list-item>
</list>
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<p><list list-type="order"><title>Research Support, Academic Entities:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Research Support, Foundations and Societies:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Stock/Stock Options/Board of Directors Compensation:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>License Fee Payments, Technology or Inventions:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Royalty Payments, Technology or Inventions:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Stock/Stock Options, Research Sponsor:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Stock/Stock Options, Medical Equipment & Materials:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Legal Proceedings:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
</author-comment>
</contrib>
<contrib contrib-type="author"><name><surname>Paul</surname>
<given-names>Robert</given-names>
</name>
<degrees>PhD</degrees>
<author-comment content-type="disclosure"><p><list list-type="order"><title>Scientific Advisory Boards:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Gifts:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Funding for Travel or Speaker Honoraria:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Editorial Boards:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Patents:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Publishing Royalties:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Employment, Commercial Entity:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Consultancies:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Speakers' Bureaus:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Other Activities:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Clinical Procedures or Imaging Studies:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Research Support, Commercial Entities:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Research Support, Government Entities:</title>
<list-item><p>National Institutes of Health 5R01NS052470 PI 2009-2014</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Research Support, Academic Entities:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Research Support, Foundations and Societies:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Stock/Stock Options/Board of Directors Compensation:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>License Fee Payments, Technology or Inventions:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Royalty Payments, Technology or Inventions:</title>
<list-item><p>NONE</p>
</list-item>
</list>
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<p><list list-type="order"><title>Stock/Stock Options, Research Sponsor:</title>
<list-item><p>NONE</p>
</list-item>
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<p><list list-type="order"><title>Stock/Stock Options, Medical Equipment & Materials:</title>
<list-item><p>NONE</p>
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<p><list list-type="order"><title>Legal Proceedings:</title>
<list-item><p>NONE</p>
</list-item>
</list>
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</author-comment>
</contrib>
<contrib contrib-type="author"><name><surname>Donald</surname>
<given-names>Kirsten A.</given-names>
</name>
<degrees>Mphil</degrees>
<author-comment content-type="disclosure"><p><list list-type="order"><title>Scientific Advisory Boards:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Gifts:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Funding for Travel or Speaker Honoraria:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Editorial Boards:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Patents:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Publishing Royalties:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Employment, Commercial Entity:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Consultancies:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Speakers' Bureaus:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Other Activities:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Clinical Procedures or Imaging Studies:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Research Support, Commercial Entities:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Research Support, Government Entities:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Research Support, Academic Entities:</title>
<list-item><p>NRF, MRC</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Research Support, Foundations and Societies:</title>
<list-item><p>Harry Crossley Foundation</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Stock/Stock Options/Board of Directors Compensation:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>License Fee Payments, Technology or Inventions:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Royalty Payments, Technology or Inventions:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Stock/Stock Options, Research Sponsor:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Stock/Stock Options, Medical Equipment & Materials:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Legal Proceedings:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
</author-comment>
</contrib>
<contrib contrib-type="author"><name><surname>Stein</surname>
<given-names>Dan J.</given-names>
</name>
<degrees>FCPsych, PhD</degrees>
<author-comment content-type="disclosure"><p><list list-type="order"><title>Scientific Advisory Boards:</title>
<list-item><p>In the past 3 years, Dr. Stein has received research grants and/or consultancy honoraria from AMBRF, Biocodex, Cipla, Lundbeck, National Responsible Gambling Foundation, Novartis, Servier, and Sun.</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Gifts:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Funding for Travel or Speaker Honoraria:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Editorial Boards:</title>
<list-item><p>I serve on several editorial boards, but am not clear that these comprise a conflict.</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Patents:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Publishing Royalties:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Employment, Commercial Entity:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Consultancies:</title>
<list-item><p>As above.</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Speakers' Bureaus:</title>
<list-item><p>As above.</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Other Activities:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Clinical Procedures or Imaging Studies:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Research Support, Commercial Entities:</title>
<list-item><p>Supported by the Medical Research Council of South Africa, as well as various agencies eg NIH.</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Research Support, Government Entities:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Research Support, Academic Entities:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Research Support, Foundations and Societies:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Stock/Stock Options/Board of Directors Compensation:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>License Fee Payments, Technology or Inventions:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Royalty Payments, Technology or Inventions:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Stock/Stock Options, Research Sponsor:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Stock/Stock Options, Medical Equipment & Materials:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Legal Proceedings:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
</author-comment>
</contrib>
<contrib contrib-type="author"><name><surname>Thomas</surname>
<given-names>Kevin G.F.</given-names>
</name>
<degrees>PhD</degrees>
<author-comment content-type="disclosure"><p><list list-type="order"><title>Scientific Advisory Boards:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Gifts:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Funding for Travel or Speaker Honoraria:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Editorial Boards:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Patents:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Publishing Royalties:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Employment, Commercial Entity:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Consultancies:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Speakers' Bureaus:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Other Activities:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Clinical Procedures or Imaging Studies:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Research Support, Commercial Entities:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Research Support, Government Entities:</title>
<list-item><p>(1) South African National Research Foundation, Grant number 90283, PI, 2014-2016</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Research Support, Academic Entities:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Research Support, Foundations and Societies:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Stock/Stock Options/Board of Directors Compensation:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>License Fee Payments, Technology or Inventions:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Royalty Payments, Technology or Inventions:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Stock/Stock Options, Research Sponsor:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Stock/Stock Options, Medical Equipment & Materials:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
<p><list list-type="order"><title>Legal Proceedings:</title>
<list-item><p>NONE</p>
</list-item>
</list>
</p>
</author-comment>
</contrib>
<aff>From the Department of Psychiatry and Mental Health (J.H., N.P., J.A.J., D.J.S.), Department of Pediatrics, School of Child and Adolescent Health (K.A.D.), and Department of Psychology (K.G.F.T.), University of Cape Town, South Africa; and Department of Psychology and Behavioural Neuroscience (R.P.), University of Missouri, St. Louis.</aff>
</contrib-group>
<author-notes><corresp>Correspondence to Dr. Hoare: <email>hoare.jax@gmail.com</email>
</corresp>
<fn fn-type="financial-disclosure"><p>Go to <ext-link ext-link-type="uri" xlink:href="http://neurology.org/lookup/doi/10.1212/WNL.0000000000002669">Neurology.org</ext-link>
for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.</p>
</fn>
</author-notes>
<pub-date pub-type="ppub"><day>05</day>
<month>7</month>
<year>2016</year>
</pub-date>
<pub-date pub-type="pmc-release"><day>05</day>
<month>7</month>
<year>2017</year>
</pub-date>
<pmc-comment> PMC Release delay is 12 months and
0 days and was based on the . </pmc-comment>
<volume>87</volume>
<issue>1</issue>
<fpage>86</fpage>
<lpage>93</lpage>
<history><date date-type="received"><day>03</day>
<month>8</month>
<year>2015</year>
</date>
<date date-type="accepted"><day>02</day>
<month>3</month>
<year>2016</year>
</date>
</history>
<permissions><copyright-statement>© 2016 American Academy of Neurology</copyright-statement>
<copyright-year>2016</copyright-year>
<copyright-holder>American Academy of Neurology</copyright-holder>
</permissions>
<self-uri xlink:title="pdf" xlink:href="NEUROLOGY2015684415.pdf"></self-uri>
<abstract><sec><title>Objective:</title>
<p>The aim of this study was to apply the HIV-associated neurocognitive disorders (HAND) criteria for diagnosing HAND in HIV-infected adults, in a cohort of HIV-infected youth to thus establish whether this system is able to detect a spectrum of neurocognitive disorders (ND) in HIV-infected youth.</p>
</sec>
<sec><title>Methods:</title>
<p>We used a comprehensive pediatric neurocognitive battery, an assessment of functional competence, and the American Academy of Neurology system for diagnosing ND in a cross-sectional study of HIV-infected youth (n = 86) and HIV-negative controls (n = 34) to establish whether this system could detect a spectrum of ND in HIV-infected youth (6–16 years).</p>
</sec>
<sec><title>Results:</title>
<p>Compared to a well-matched control group of HIV-negative youth, HIV-infected youth performed significantly more poorly on tests of Verbal IQ, Full Scale IQ, processing speed, finger tapping, verbal memory, expressive language, cognitive flexibility, and inhibition. HIV-infected youth were also more likely to have impaired total competence on the Child Behavior Checklist. Using the criteria for HAND, we found that 45.35% of the 86 HIV-infected youth could be diagnosed with an ND. Furthermore, youth with HIV encephalopathy (HIVE) were 9.4 times more likely to have a diagnosis of a major ND compared to HIV-infected youth without HIVE.</p>
</sec>
<sec><title>Conclusions:</title>
<p>The HAND criterion designed for adults was able to identify youth with important functional cognitive impairments who do not fit criteria for HIVE and would therefore not have been identified otherwise. This has major clinical implications regarding the importance of managing HIV-infected youth.</p>
</sec>
</abstract>
<funding-group><award-group><funding-source>National Research Foundation (NRF)</funding-source>
</award-group>
<award-group><funding-source>Medical Research Council (MRC) of South Africa</funding-source>
</award-group>
</funding-group>
</article-meta>
</front>
</pmc>
</record>
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