Dr. José A. Muñoz-Moreno, psychologist at the Fight AIDS Foundation, presented at the CROI (Conference on Retroviruses and Opportunistic Infections) a paper entitled "Accuracy of NEU Screen for Detecting Cognitive Impairment in Virologically Suppressed HIV Patients". He is its first author, but the other professionals had also contributed from the Fight AIDS Foundation, Autonomous University, the Polytechnic University of Catalunya, Terrassa Health Consortium, the Consolidated Research Group on Neuropsychology of the University of Barcelona, AIDS Research Institute IrsiCaixa and the University of Vic.
In August 2013, the journal JAIDS published the emergence of a new clinical method for early detection of abnormalities that HIV can cause in the central nervous system, the NEU screen. This method resulted from the NEU study, the first multicenter study in Spain on detection of neurocognitive impairment in HIV population.
Until then, other methods had been proposed for the detection of cognitive impairment in HIV infection, but none has yet managed to consolidate in routine clinical practice: neuropsychological evaluations require specialized a neuropsychologist who can apply them, involve too much time to be performed, time to get the results, require the use of specific tests, etc.
The NEU, however, is a practical, short and accessible method: the time required to implement this instrument is less than 10 minutes and it is a paper-based test. The patient tis asked o develop certain tasks to measure information processing speed, executive functioning and verbal fluency. After completing this process, each patient gets a score to establish impairment suspected or not.
In the new work presented at the CROI, researchers have tried to study the accuracy of the NEU method in detecting cognitive impairment in different profiles of HIV patients. They have used information from 156 patients of the HIV Unit of Germans Trias i Pujol University Hospital, who were selected to be over 18 years old, have had an undetectable viral load during the last six months and had not participated in the first study on the NEU.
Cognitive impairment was detected in 82 patients (52% of participants). Among them, 42 people (54%) complained of cognitive changes. The degree of impairment was significantly related to the time that had passed since HIV diagnosis: the longer infection, further deterioration.
When the different subgroups were compared, greater accuracy of the NEU instrument was observed detecting cognitive impairment in women, patients with less than 8 or more than 16 years of education, and people with a time of diagnosis less than 5 years. It seems therefore that demographic and clinical factors, such as gender, educational level or immune status, may play an important role in the accuracy of the methods for detecting cognitive impairment in people with HIV.