The Human Immunodeficiency Virus (HIV) is a neurotropic virus that is associated with cognitive, behavioral and motor deficits known as HIV Associated neurocognitive Disorder. This was a prospective study aimed at determining the prevalence of neurocognitive impairment using both a screening test, the International HIV Dementia Scale (IHDS), and subtests drawn from a neuropsychological test battery, the WHO/UCLA test battery. The screening test and neuropsychological test battery were administered to HIV positive subjects while the HIV negative patients had only the test battery administered. The performance of the HIV negative subjects was used to determine the mean score for each test domain of the test battery. Neurocognitive impairment was defined using the cut-off score of 10 for the IHDS and Z scores greater than 1 SD in at least two domains of the neuropsychological test battery. Ninety-two positive patients (57 females and 35 males) and ninety-two age, sex and education matched HIV negative subjects (46 females and 46 males) were enrolled into the study. The median age and interquartile range were 33(26-39) and 35(27-46) for the HIV positive and negative subjects respectively. The prevalence estimates of cognitive impairment determined by the IHDS and the test battery were 42.4% and 76.1% respectively. The IHDS in this study was found to have a sensitivity of 50% and a specificity of 81% for HAND. Neurocognitive impairment still persists in the combined anti-retroviral therapy (cART) era and is better ascertained using neuropsychological testing than with screening test. However, neuropsychological testing is cumbersome and requires expertise and patience for both the patients and researchers.

Keywords: HIV, Neurocognitive disorder, Sub-Saharan Africa, Dementia tests, Neuropsychology