Utility of a brief computerized battery to assess HIV-associated neurocognitive impairment in a resource-limited setting.

Journal Article (Journal Article)

Despite the persistently high prevalence of neurocognitive impairment in HIV-positive patients, routine HIV care in many resource-limited settings does not include neuropsychological assessment. The objective of this study was to examine the utility of a brief computerized battery for identifying neurocognitive impairment in a busy HIV clinic in Uganda. Specifically, we compared performance on a gold standard neuropsychological exam to that on the CogState Brief Battery. In this cross-sectional study, 181 HIV-positive patients completed both assessment batteries in a randomized order. The primary outcome measures were neurocognitive impairment on the standard exam defined by the global deficit score and cumulative performance on the CogState Brief Battery. Sixty-nine participants (38 %) were classified as impaired on the standard neuropsychological exam, and participants who were classified as impaired performed significantly worse on CogState compared to those who were unimpaired (p < 0.001). CogState had adequate specificity but low sensitivity, suggesting that it may not be a clinically useful screening tool to identify patients who likely have neurocognitive impairment in Uganda. This study supports the feasibility of using a computerized battery for assessing neurocognitive impairment in HIV-positive patients in resource-limited settings, but additional research is needed to identify screening tools with higher sensitivity for use in HIV clinics.

Full Text

Duke Authors

Cited Authors

  • Yechoor, N; Towe, SL; Robertson, KR; Westreich, D; Nakasujja, N; Meade, CS

Published Date

  • December 2016

Published In

Volume / Issue

  • 22 / 6

Start / End Page

  • 808 - 815

PubMed ID

  • 27245592

Pubmed Central ID

  • PMC5130618

Electronic International Standard Serial Number (EISSN)

  • 1538-2443

Digital Object Identifier (DOI)

  • 10.1007/s13365-016-0456-1


  • eng

Conference Location

  • United States