One of the common side effects of HIV and AIDS is neurocognitive impairments - changes in how fast a person can process information, pay attention, multi-task and remember things - yet there are no adequate tests to screen patients for these problems, according to a new study out of St. Michael's Hospital.
The incidence of severe forms of HIV-associated neuorcognitive disorders, or HAND, has declined significantly with the availability of combination antiretroviral drug therapy over the last 20 years.
But the prevalence of the milder form has remained stable and even slightly increased, affecting 50 to 60 per cent of people living with HIV and AIDS.
"Screening tools have not been updated to reflect this change," said Dr. Sean B. Rourke, a neuropsychologist who heads the Neurobehavioural Research Unit at St. Michael's. "We are still trying to use or adapt the older dementia screening tools to catch the milder form of HAND."
Dr. Rourke said that having effective screening tests to identify and differentiate the two different forms of HAND is important for treatment decision-making. The current standards of practice requires a detailed neuropsychological examination, which is time-consuming and not readily accessible.
"Identifying that patients have a mild form of this condition is critical," said Dr. Rourke. "Even mild neurocognitive problems can have a significant impact on a person's everyday functioning, affecting his or her ability to take medications or ability to perform at work, and may also lead to more social isolation and withdrawal."
In a review of literature published in the journal AIDS, Dr. Rourke and colleagues looked at 31 previously published studies to see the rate at which commonly used tools in practice were detecting milder forms of HAND.
