Utility of the International HIV Dementia Scale for HIV-Associated Neurocognitive Disorder

BACKGROUND: We assessed the utility of the International HIV Dementia Scale (IHDS) in detecting HIV-associated neurocognitive disorder (HAND) in Uganda in antiretroviral (ART)-naive and ART-experienced adults. SETTING: A longitudinal observational cohort study in Rakai, Uganda. METHODS: Three hundred ninety-nine HIV+ ART-naive adults underwent neurological, functional status, and neuropsychological assessments including the IHDS. Three hundred twelve participants who initiated ART were re-evaluated after 2 years. HAND stages [asymptomatic neurocognitive impairment, mild neurocognitive disorder, and HIV-associated dementia (HAD)] were determined based on Frascati criteria using local normative data. Sensitivity, specificity, and area under the ROC curve were determined for various IHDS thresholds (