Cross-sectional analysis of cognitive function using multivariate normative comparisons in men with HIV disease

Area of Science:

• Neuroscience
• Infectious Diseases
• Psychiatry

Background:

• Cognitive impairment prevalence in HIV varies significantly.
• Existing diagnostic criteria like Frascati and Gisslén may lack specificity.
• Accurate assessment is crucial for managing HIV-associated neurocognitive disorders.

Purpose of the Study:

• To evaluate the effectiveness of multivariate normative comparison (MNC) in identifying cognitive impairment.
• To compare MNC's performance against established Frascati and Gisslén criteria.
• To assess cognitive impairment in seronegative and seropositive individuals within the Multicenter AIDS Cohort Study.

Main Methods:

• Utilized data from 2904 bisexual/gay men from the Multicenter AIDS Cohort Study (MACS).
• Applied multivariate normative comparison (MNC) to six cognitive domains.
• Compared MNC results with Frascati and Gisslén criteria for impairment detection.

Main Results:

• MNC identified 6.26% of seronegative men as impaired, compared to 24.54% (Frascati) and 11.36% (Gisslén).
• For seropositive men, MNC identified 7.45% impairment versus 25.73% (Frascati) and 11.69% (Gisslén).
• Serostatus was not associated with cognitive impairment across all methods when controlling for comorbidities.

Conclusions:

• MNC demonstrates superior specificity by controlling the false discovery rate, unlike Frascati and Gisslén criteria.
• Further research is needed to validate MNC's sensitivity in diverse HIV-positive populations, including women.
• MNC presents a promising, more accurate method for diagnosing cognitive impairment in HIV.