Is the use of the QPC cognitive complaints questionnaire relevant for the screening strategy of HIV-Associated neurocognitive disorders?

AIDS Care. 2021 Mar;33(3):389-397. doi: 10.1080/09540121.2020.1738008. Epub 2020 Apr 11.

Abstract

Background: The screening strategy for HIV-Associated Neurocognitive Disorders (HAND) is challenging. The French Expert Report recommend the use of the Cognitive Complaints Questionnaire (QPC) and the Montreal Cognitive assessment. However, the QPC has never been studied in People Living with HIV (PLWH). This study aims to determine the degree of agreement between QPC and the presence of HAND according to Frascati criteria, established by a battery of neuropsychological tests.

Methods: Data from patients who performed both a QPC and a battery of neuropsychological tests over a six-month follow-up period were evaluated retrospectively.

Results: A total of 121 patients were selected, with a median age of 53.1 years old. Among participants, 92.6% had an undetectable plasma viral load, 49.6% had a nadir CD4 less than 200/mm3 and 23.1% had a CDC stage C. Median CD4 cell count was 686/mm3. Prevalence of HAND was 57%, including 28.9% of Asymptomatic Neurocognitive Impairment, 24.8% of Mild Neurocognitive Disorder and 3.3% of HIV-associated Dementia. This analyze shows no agreement between QPC and HIV-associated neurocognitive disorders (kappa = -0.007).

Conclusions: The QPC is not relevant in the screening for HAND. Thus, it urges to develop a specific tool to assess cognitive complaints among PLWH.

Keywords: “Cognitive complaints”; “HIV-associated neurocognitive disorders”; “HIV”; “Neurocognitive impairment”; “QPC”.

MeSH terms

  • AIDS Dementia Complex / diagnosis*
  • AIDS Dementia Complex / epidemiology
  • AIDS Dementia Complex / psychology
  • AIDS Dementia Complex / virology
  • Anti-HIV Agents / administration & dosage
  • Anti-HIV Agents / therapeutic use
  • Antiretroviral Therapy, Highly Active
  • Cognition / physiology
  • Cross-Sectional Studies
  • Female
  • HIV Infections / complications*
  • HIV Infections / drug therapy
  • Humans
  • Male
  • Mass Screening / methods*
  • Middle Aged
  • Neurocognitive Disorders / diagnosis*
  • Neurocognitive Disorders / epidemiology
  • Neurocognitive Disorders / etiology
  • Neuropsychological Tests
  • Retrospective Studies

Substances

  • Anti-HIV Agents