{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T09:53:13Z","timestamp":1784886793571,"version":"3.55.0"},"reference-count":22,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2020,9,23]],"date-time":"2020-09-23T00:00:00Z","timestamp":1600819200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["HIV Medicine"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>We aimed to assess the Addenbrooke\u2019s Cognitive Examination Revised (ACE\u2010R) and three questions (3Qs, European Aids Clinical Society Guidelines) as potential screening tools for HIV\u2010associated neurocognitive disorder (HAND). In addition, we tried to determine the prevalence and associated factors for HAND among people living with HIV (PLWH) in Turkey.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Persons living with HIV were enrolled from two teaching hospitals between March 2018 and September 2018. Participants underwent screening tools, a neuropsychological test battery (NTB) and an assessment of activities of daily living. HAND was diagnosed according to Frascati's criteria and applying the Global Deficit Score (GDS) approach. A receiver operating characteristic (ROC) curve analysis was performed to compare the predictive accuracy of ACE\u2010R to that of the NP test battery. Factors associated with HAND were evaluated using multivariate logistic regression analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The study sample included 162 participants (94% male). The HAND prevalence was 45.7% [asymptomatic neurocognitive impairment (ANI), 37.7%; mild neurocognitive disorder (MND), 7.4%; HIV\u2010associated dementia (HAD), 0.6%] according to the Frascati criteria and 31.5% (ANI, 25.9%; MND, 4.9%; HAD, 0.6%) using the GDS. In the ROC analysis, the ACE\u2010R showed an area under the curve of 0.68 at a cut\u2010off score of 89. The sensitivity, specificity and correct classification rate of screening tests for HAND diagnosis were as follows: ACE\u2010R (62.2%, 67%, 64.8%) and 3Qs (10.8%, 88.6%, 53%). In multivariate analysis, only education level (adjusted odds ratio [aOR] = 0.84, 95% CI: 0.76\u20130.92, <jats:italic>P\u00a0<\/jats:italic>\u2264\u00a00.001) was an independent risk factor for HAND.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>HAND is a common comorbidity in PLWH in Turkey. The sensitivities and specificities of 3Qs and the ACE\u2010R as screening tools are lower than desired.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hiv.12957","type":"journal-article","created":{"date-parts":[[2020,9,23]],"date-time":"2020-09-23T09:40:06Z","timestamp":1600854006000},"page":"60-66","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Prevalence of HIV\u2010associated neurocognitive disorder (HAND) in Turkey and assessment of Addenbrooke\u2019s Cognitive Examination Revised (ACE\u2010R) test as a screening tool"],"prefix":"10.1111","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9991-814X","authenticated-orcid":false,"given":"V","family":"Korten","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases Marmara University School of Medicine Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7896-3681","authenticated-orcid":false,"given":"U","family":"Ay","sequence":"additional","affiliation":[{"name":"Department of Neuroscience Aziz Sancar Experimental Medicine Research Institute Istanbul University \u00c7apa, Istanbul Turkey"},{"name":"Hulusi Behcet Life Sciences Research Laboratory Neuroimaging Unit Istanbul University Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8329-5507","authenticated-orcid":false,"given":"E","family":"Har\u0131","sequence":"additional","affiliation":[{"name":"Department of Neuroscience Aziz Sancar Experimental Medicine Research Institute Istanbul University \u00c7apa, Istanbul Turkey"},{"name":"Hulusi Behcet Life Sciences Research Laboratory Neuroimaging Unit Istanbul University Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2027-4116","authenticated-orcid":false,"given":"E","family":"Tigen T\u00fckenmez","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Marmara University School of Medicine Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3217-6305","authenticated-orcid":false,"given":"S","family":"Gencer","sequence":"additional","affiliation":[{"name":"Lutfi K\u0131rdar Hospital Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5597-3684","authenticated-orcid":false,"given":"S","family":"Ak\u00e7a Kalem","sequence":"additional","affiliation":[{"name":"Istanbul Faculty of Medicine Department of Neurology Behavioural Neurology and Movement Disorders Unit Istanbul University \u00c7apa, Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2050-5674","authenticated-orcid":false,"given":"A","family":"Demirta\u015f Tatl\u0131dede","sequence":"additional","affiliation":[{"name":"Istanbul Faculty of Medicine Department of Neurology Behavioural Neurology and Movement Disorders Unit Istanbul University \u00c7apa, Istanbul Turkey"},{"name":"Department of Neurology Bahcesehir University Faculty of Medicine Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2908-8475","authenticated-orcid":false,"given":"\u0130H","family":"G\u00fcrvit","sequence":"additional","affiliation":[{"name":"Istanbul Faculty of Medicine Department of Neurology Behavioural Neurology and Movement Disorders Unit Istanbul University \u00c7apa, Istanbul 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Available athttps:\/\/www.eacsociety.org\/files\/2019_guidelines\u201010.0_final.pdf(accessed 1 Dec 2019)."},{"key":"e_1_2_8_14_1","first-page":"45","article-title":"Neurologic complications of HIV disease and their treatment","volume":"18","author":"Letendre SL","year":"2010","journal-title":"Top HIV Med"},{"key":"e_1_2_8_15_1","first-page":"ofz277","article-title":"Neurocognitive Assessment in the Metabolic and Aging Cohort (NAMACO) Study Group. Cross\u2010sectional and cumulative longitudinal central nervous system penetration effectiveness scores are not associated with neurocognitive impairment in a well treated aging human immunodeficiency virus\u2010positive population in Switzerland. 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