Assessment of neurocognitive disorders in patients with HIV infection

      Introduction: Neurocognitive disorders associated with HIV infection (NDAH) are relatively common manifestations that may affect the everyday functionality and patient adherence to treatment. Currently we have no validated screening tools for early detection of these disorders that can be made in the routine visit. Montreal Cognitive Assessment (MoCA) test is a multidimensional tool, rapid deployment that has already been validated in Alzheimer's disease and allows the evaluation of several domains.
      Objective: To determine the usefulness of MoCA as a quick, sensitive and specific tool for the detection of NDAH, compared to a comprehensive cognitive evaluation and MiniMental Test (MMSE).
      Materials and methods: Patients over 18 years old with HIV infection were included in a prospective study. MoCA test, Beck Depression Scale and a comprehensive neurocognitive battery were performed. Sex, age, education, length of infection by the HIV virus, CD4 and viral load at the time of evaluation were analyzed.
      Results: we evaluated 21 patients, 19 male; mean age 46.9 years, education 14 years, time of infection by HIV 60 months and median CD4 563 cells/ml. 13/21 had undetectable viral load. MoCA presented 66.67% S (IC34.95–89.87%), E 88.89% (CI 51.7498.16%). VPP 88.89% (CI 51–98%) and VPN 66.67 (CI 35–90%). MMSE results were analyzed, showing 9.9% S (IC1, 5–41%) E 100% (CI 69–100%) VPP100% (CI 16–100%) and NPV 50% (IC27–73%).
      Conclusions: MoCA is a good screening test for NDAH, higher than MMSE. The continuation of this cohort will help to determine the usefulness of this tool in clinical practice.