RBANS: un valido strumento di valutazione cognitiva in soggetti HIV-infetti in cART = RBANS: a valid tool for cognitive assessment of HIV-infected people on cART

Introduction. Combination Antiretroviral Therapy (cART) has dramatically modified prognosis of individuals with HIV infection, and also the HIV-Associated Neurocognitive Disorders (HAND) spectrum, with reduction of the most severe form of HAND, HIV-Associated Dementia (HAD), but with persistence of the milder forms (ANI: Asymptomatic Neurocognitive Impairment; MND: Mild Neurocognitive Disorder). Screening of HAND requires efficient tools. The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) is a tool that is fast and easy to use, and which is able to assess different cognitive domains. Our purpose is to evaluate the utility of RBANS in screening HAND. Materials and methods. 95 HIV-infected patients (mean age 47.8 +/- 8.0, range 26-74 years; mean duration of infection 17.0 +/- 8.5, range 1-32 years) on cART, run by Internal Medicine, Allergology and Clinical Immunology, University of Cagliari, underwent neuropsychological assessment with MMSE, Clock Test and RBANS. Results obtained were compared with participants in the RBANS validation study for the Italian population (control group). Results. Mean scores in MMSE and Clock Test were 29.3 +/- 1.3 and 8.5 +/- 1.4, respectively, indicative of normal cognitive abilities. In RBANS evaluation, however, the total index score was significantly lower than the mean of the control group (84.9 +/- 13.6, P < 0.001), as were indices of immediate memory (82.4 +/- 14.1), language (91.2 +/- 10), attention (87.9 +/- 16.1) and delayed memory (87.3 +/- 17.6). Conclusions. Our results support the utility of RBANS for identification of HAND in HIV-infected people on cART.