The importance of cognitive self-report in early HIV-1 infection: validation of a cognitive functional status subscale.

Abstract

The Medical Outcomes Study HIV (MOS-HIV) Health Survey is a widely used instrument to assess quality of life in HIV-1-infected individuals. Its cognitive functional status subscale measures functional status owing to neuropsychological (NP) impairment. To determine the concurrent validity of the Dutch four-item MOS-HIV cognitive functional status subscale and its clinical significance in predicting NP test performance. Cross-sectional analysis of baseline data collected between October, 1994, and March, 1997, in the Netherlands and in Flanders, Belgium. A total of 85 HIV-1-infected homosexual men who participated in an ongoing longitudinal research project designed to study the effects of a support group. The MOS-HIV cognitive functional status subscale showed significant associations with NP test performance overall and, specifically, with the domains of abstraction, language and visuospatial abilities, controlling for CD4 cell count and Centers for Disease Control and Prevention (CDC) clinical disease stage. A trend toward significance was also found in the memory domain. To our knowledge, this is the first report of a cognitive functional status subscale used with HIV-1-infected subjects in a language other than English. The MOS-HIV cognitive functional status subscale seems particularly sensitive to changes in NP test performance in early HIV-1 infection. These results suggest the potential for clinical utility of a brief functional status self-report measure related to cognitive abilities in early HIV-1 infection for the screening and diagnosis of HIV-1 associated cognitive-motor disorders.