The Wide Range Achievement Test–4 Reading subtest “holds” in HIV-infected individuals

Abstract

Background: In order to detect HIV-associated neurocognitive decline, it is important to accurately estimate individuals’ premorbid levels of cognitive functioning. Although previous studies have operated under the assumption that word reading tests are valid and stable indicators of premorbid abilities in HIV infection, studies of other populations have found that this is not always the case. Therefore, it is important to empirically examine the validity of word reading tests as estimates of premorbid functioning specifically within the HIV population. Method: The Wide Range Achievement Test–4 Reading subtest (WRAT–4 Reading) was administered along with comprehensive neurocognitive assessments to 150 HIV seropositive (HIV+) and 76 HIV seronegative (HIV–) age-, education-, and sex-matched participants; a subset of 48 HIV+ individuals completed a second study visit (M = 14.4 months), in which the alternate version of the WRAT–4 was administered. Results: Although HIV+ individuals evidenced worse current neurocognitive functioning than HIV– participants, WRAT–4 Reading performance was comparable between groups. Longitudinally, HIV+ participants evidenced improved disease and neuropsychological functioning, yet WRAT–4 Reading demonstrated strong test–retest reliability and no practice effect, and did not differ between the initial and follow-up assessments. Test–retest differences in reading performance were minor and were not associated with changes in neurocognitive performance or changes in HIV disease. Conclusions: We found no evidence of WRAT–4 Reading performance decline in HIV infection, despite HIV+/HIV– group differences in neurocognitive functioning. Additionally, reading performances among HIV+ individuals demonstrated consistency across study visits. These results begin to support the validity of the WRAT–4 Reading subtest as an indicator of premorbid cognitive functioning in HIV+ individuals.