ArticleAIDS (London, England)2018
Limitations of the International HIV Dementia Scale in the current era.
Article in AIDS (London, England), 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
26 citing papers in PubMed, 1 synthesis or guideline pooled it, 35 citations in OpenAlex.
- Risk factors for HIV-associated neurocognitive impairment and frailty in aging people with HIV in Latin America: a systematic review.BMC neurology · 2026Pooled it
- Clinical and behavioral predictors of HIV-associated neurocognitive disorder among people with HIV who use substances: a secondary analysis of the HOPE trial.Journal of neurovirology · 2026Trial
- Article
- Development and Validation of a Brief Digital Cognitive Screening Tool for HIV-associated Neurocognitive Disorder in Lima, Peru.Research square · 2026Article
- Facilitators and Barriers to Implementing Peer-Led Neurocognitive Screening for Older Adults Living With HIV at a Community Hospital in Thailand: A Multiple-Methods Study.Journal of the International AIDS Society · 2026Article
- Diagnostic accuracy of IHDS and MoCA in screening for HIV-associated neurocognitive disorders among adults living with HIV in Ethiopia.International journal of mental health systems · 2026Article
- The Transformative Impact of the African Cohort Study (AFRICOS) Toward Reaching HIV 95-95-95 Goals in Sub-Saharan Africa.The American journal of tropical medicine and hygiene · 2025Article
- Cognitive Impairment in People Living with HIV and the Impact of Mood: Results from a Cross-Sectional Study.Journal of clinical medicine · 2024Article
- Centring the health of women across the HIV research continuum.The lancet. HIV · 2024Review
- Cerebral abnormalities in HIV-infected individuals with neurocognitive impairment revealed by fMRI.Scientific reports · 2023Article
- The NeuroinflammatoryPotential of HIV-1 NefVariants in Modulating the Gene Expression Profile of Astrocytes.Cells · 2022Article
- Screening Accuracy of Mini Addenbrooke's Cognitive Examination Test for HIV-Associated Neurocognitive Disorders in People Ageing with HIV.AIDS and behavior · 2022Article
- Validity of Digital Assessments in Screening for HIV-Related Cognitive Impairment: a Review.Current HIV/AIDS reports · 2021Review
- Tablet-Based Cognitive Impairment Screening for Adults With HIV Seeking Clinical Care: Observational Study.JMIR mental health · 2021Article
- Psychometric utility of the international HIV dementia scale and Montreal Cognitive Assessment in HIV-associated asymptomatic neurocognitive impairment.Journal of neurovirology · 2021Article
- Rates of cognitive impairment in a South African cohort of people with HIV: variation by definitional criteria and lack of association with neuroimaging biomarkers.Journal of neurovirology · 2021Article
- International HIV Dementia Scale for HIV-Associated Neurocognitive Disorders: A Systematic Review and Meta-Analysis.Diagnostics (Basel, Switzerland) · 2021Review
- Article
- Neurocognitive outcomes of tuberculous meningitis in a primarily HIV-positive Ugandan cohort.Wellcome open research · 2021Article
- HIV-associated neurocognitive disorders at Moi teaching and referral hospital, Eldoret, Kenya.BMC neurology · 2020Article
Corrections and comments
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Authors and funding
12 authors at 7 institutions in 3 countries.
Funding
Abstract
objectiveThe International HIV Dementia Scale (IHDS) was developed as a tool to detect HIV-dementia in both industrialized and resource-limited settings. Studies employing the IHDS have produced mixed results, with recent data suggesting unusually high rates of dementia among Ugandans. This study aimed to define the performance characteristics of the IHDS in three African countries.
designCross-sectional study.
methodsWe recruited 2208 HIV-infected and 429 HIV-uninfected individuals from East Africa (Kenya n = 1384; Tanzania n = 368; Uganda n = 456) who underwent testing with the IHDS and a 30-min neuropsychological testing battery. Cognitive impairment was defined as -1SD on two of six tests or -2SD on one test compared with demographically matched controls stratified by age and education. We examined predictive capacity of the IHDS to detect cognitive impairment using receiver-operator characteristic (ROC) curve analysis.
resultsThe mean (SD) ages of the HIV-infected and HIV-uninfected groups were 39.7 (10.7) and 37.4 (10.4), respectively. Among HIV-infected individuals, 1508 (68%) were on combination antiretroviral therapy (cART), 1298 (61%) had plasma viral load less than 500 copies/ml and 884 (38%) met criteria for cognitive impairment. Using the customary IHDS cut-off of 10, 1136 (83%) of the HIV-infected participants met criteria for dementia resulting in 91% sensitivity but only 17% specificity. A modified cut-off score of 8 derived from the ROC resulted in low sensitivity (56%) and specificity (64%).
conclusionThe IHDS has poor performance characteristics for the identification of cognitive impairment in East Africa. Cultural-informed and sensitive screening tests are needed to detect mild cognitive dysfunctions in developing countries.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.