Abstract
Objective: The purpose of this study was to develop a new Japanese neuropsychological test to detect cognitive disorders including ADC in patients with HIV infection.
Materials and Methods: The English version of HIV dementia scale (HDS) was translated into Japanese. The subset of timed written alphabets was changed to the subset of timed written Japanese characters (Hiragana), in the Japanese version of the HIV dementia scale (JHDS). After obtaining their informed consent, JHDS was administered to 32 HIV positive patients and 99 seronegative volunteers as controls. Thiry-nine of the 99 HIV negative volunteers were tested with two instruments, the Minimental State Examination (MMSE) and JHDS.To assess the reproducibility of the JHDS, 20 HIV negative volunteers were retested by a different examiner at 4 weeks after the initial assessment.
Results: JHDS was relatively independent from effects of age, sex, years of education, serostate of HIV infection, and the number of CD4 cell counts. It is easier to evaluate the score of JHDS, compared to other neuropsychological tests that are affected by sociodemographic factors, medical factors, etc. Analysis of variance (ANOVA) revealed a significant relationship between the JHDS score and the presence or absence of ADC (F=29.17, p<0.0001). The score of JHDS only reflected the severity of ADC and decreased with the progression of the stage of ADC. The score of ≤10 was the optimal point of JHDS (the sensitivity and specificity were 1.00 and 0.89 respectively) for diagnosing ADC. The correlation coefficient between the initial scores and the second scores was 0.65 (p=0.0027). The reproducibility of JHDS was confirmed. The scores of JHDS were significantly correlated to those of the MMSE (standardized regression coefficient=0.42, p=0.009).
Conclusion: JHDS was a useful device to detect ADC in patients with HIV infection and the score of JHDS was taken into consideration when diagnosingand evaluating the stage of ADC.
