Classification models for neurocognitive impairment in HIV infection based on demographic and clinical variables

Jose A. Muñoz-Moreno, Núria Pérez-Álvarez, Amalia Muñoz-Murillo, Anna Prats, Maite Garolera, M. Ángels Jurado, Carmina R. Fumaz, Eugénia Negredo, Maria J. Ferrer, Bonaventura Clotet

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14 Citations (Scopus)

Abstract

© 2014 Muñoz-Moreno et al. Objective: We used demographic and clinical data to design practical classification models for prediction of neurocognitive impairment (NCI) in people with HIV infection.Methods: The study population comprised 331 HIV-infected patients with available demographic, clinical, and neurocognitive data collected using a comprehensive battery of neuropsychological tests. Classification and regression trees (CART) were developed to btain detailed and reliable models to predict NCI. Following a practical clinical approach, NCI was considered the main variable for study outcomes, and analyses were performed separately in treatment-naïve and treatment-experienced patients.Results: The study sample comprised 52 treatment-naïve and 279 experienced patients. In the first group, the variables identified as better predictors of NCI were CD4 cell count and age (correct classification [CC]: 79.6%, 3 final nodes). In treatment-experienced patients, the variables most closely related to NCI were years of education, nadir CD4 cell count, central nervous system penetration-effectiveness score, age, employment status, and confounding comorbidities (CC: 82.1%, 7 final nodes). In patients with an undetectable viral load and no comorbidities, we obtained a fairly accurate model in which the main variables were nadir CD4 cell count, current CD4 cell count, time on current treatment, and past highest viral load (CC: 88%, 6 final nodes).Conclusion: Practical classification models to predict NCI in HIV infection can be obtained using demographic and clinical variables. An approach based on CART analyses may facilitate screening for HIV-associated neurocognitive disorders and complement clinical information about risk and protective factors for NCI in HIV-infected patients.
Original languageEnglish
Article numbere107625
JournalPLoS ONE
Volume9
Issue number9
DOIs
Publication statusPublished - 19 Sep 2014

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