PONE-D-21-03610

Quality of life in people living with HIV-associated neurocognitive disorder: A scoping review

PLOS ONE

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Reviewers' comments:

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Reviewer #1: Yes

Reviewer #2: Yes

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Reviewer #1: Yes

Reviewer #2: N/A

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Reviewer #1: Yes

Reviewer #2: Yes

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Reviewer #1: Yes

Reviewer #2: Yes

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5. Review Comments to the Author

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Reviewer #1: Review for manuscript titled: Quality of life in people living with HIV-associated neurocognitive disorder: A scoping review.

Journal: Plos One

General comments. This review examines a very important, and often neglected, aspect of living with HIV-associated cognitive impairment. The authors use the phrases “PLWH with HAND” and “PLWH and HAND” interchangeably. Either or are fine, but can the authors please be consistent? There are some minor grammatical errors throughout the manuscript.

Introduction. The literature review is well structured and the authors covers a substantive amount of relevant literature in the field of HIV-associated cognitive disorders and how this may affect quality of life. The extensive literature review paves the way for a strong rationale.

Methodology. The methods followed are clear and replicable. The sub-heading “search strategy” on line 174 should be changed to “search results” or “search strategy outcomes” since the actual results of the search strategy are discussed in this section. The search strategy itself is described earlier in the methods section. The authors use the PRISMA diagram to visually represent their results and also provide the PRISMA checklist for scoping review, but have chosen a framework by Arksey and O’Malley (2005) to guide their methodology. Please can the authors elaborate on this choice and explain why they deem it appropriate to apply this framework in conjunction to the PRISMA statement. Please can the authors include in the manuscript, a statement on what makes a scoping review different from a systematic review when the ultimate goal of both is to describe the depth and breadth of the state of science in a particular area/topic and how this review fits into that definition. In the PRISMA diagram, please check for a typo in the block “records after duplicates removed n=460”. This number should be 547 as these are the records AFTER duplicates were removed. Alternatively change the text in the block to read “duplicate records removed n =460”. The image quality of the PRISMA diagram is not very good, please can the authors provide a 600dpi image or use the word template for PRISMA diagrams provided on the PRISMA statement website.

Results. Table 2 of the results provides a very good overview of the studies included and their findings. The authors report that 4 of the included studies did not include gender distinctions. Given that some neuropsychological tests take gender into consideration when doing the scaled scoring it would be important to check which neuropsychological tests these studies used to classify HAND. Regardless of the study aims, standard neuropsychological test scoring according to the test manuals needs to be observed, so it may be that these studies did not report the gender distinctions as opposed to it being a methodological matter. For the Canadian study that was included regardless of the treatment status of the participants, it is confirmed that the data reported in that study was collected in the accessible ART era even though the publication date was 2018?

Discussion. The discussion is well written and provides a good dialogue and argument for including quality of life into routine care for PLWH both with and without cognitive impairment. What the discission is missing is the closing of the circle for the case to include quality of life into the 90-90-90 WHO targets. The authors identify the main strength of this review as being the systematic way in which it was conducted. While I agree that this is a strength of this review, I feel that this secondary to the very important dialogue this review has paved way for. The results, and the argument created in the discussion make a very strong case indeed for having quality of life added into the 90-90-90 targets and this should be emphasized more in the discussion. I do not agree that the stringent criteria applied to the assessment of cognitive impairment is a limitation of this study. This should be added to the strengths of the study because these criteria ensure that a proper gold standard method was used to asses HIV-associated cognitive disorders in the included studies. A possible limitation of this study is the paucity of studies from sub-Saharan Africa. The impact of socioeconomic status on quality of life has not been acknowledged, and while other reviews have been excluded from the search strategy, the authors should acknowledge a recent review and meta-analysis published in 2020. Although this review does not specifically assess quality of life in HIV+ persons with cognitive impairment, important assertions are made regarding social and other determinant of quality of life in PLWH.

Ghiasvand, Hesam, Peter Higgs, Mehdi Noroozi, Gholamreza Ghaedamini Harouni, Morteza Hemmat, Elahe Ahounbar, Javad Haroni, Seyran Naghdi, Ali Nazeri Astaneh, and Bahram Armoon. "Social and demographical determinants of quality of life in people who live with HIV/AIDS infection: evidence from a meta-analysis." Biodemography and social biology 65, no. 1 (2020): 57-72.

Reviewer #2: This is a well written and important study that provides an essential review of the current literature and data about how having HIV neurocognitive impairment (NCI) affects quality of life (QoL). This is an important and thorough review that will inform the field. There are, however, some issues that need addressing. First, HIV Associated Neurocognitive Disorder (HAND) is not a clinical diagnosis. It is used for research purposes. The authors should make this important distinction. ICD-10 or DSM-V clinical diagnoses for HIV-associated neurocognitive problems require different criteria than the Frascati criteria. Second, the authors may wish to consider discussing that screening and diagnosing HIV associated NCIs remain very limited in many clinical settings [see for example 1-6] as do services for HAND [see for example 7].

1. Barber TJ, Bradshaw D, Hughes D, Leonidou L, Margetts A, Ratcliffe D, Thornton S, Pozniak A, Asboe D, Mandalia S, Boffito M, Davies N, Gazzard B, Catalan J. Screening for HIV-related neurocognitive impairment in clinical practice: Challenges and opportunities. AIDS Care. 2013:1-9.

2. Haddow LJ, Accoroni A, Cartledge JD, Manji H, Benn P, Gilson RJC. Routine detection and management of neurocognitive impairment in HIV-positive patients in a UK centre. International Journal of STD & AIDS. April 30, 2013 2013.

3. Morley D, McNamara P, Kennelly S, McMahon G, Bergin C. Limitations to the identification of HIV-associated neurocognitive disorders in clinical practice. HIV Medicine. 2013.

4. The Mind Exchange Working Group. Assessment, Diagnosis, and Treatment of HIV-Associated Neurocognitive Disorder: A Consensus Report of the Mind Exchange Program. Clinical Infectious Diseases. April 1, 2013 2013;56(7):1004-1017.

5. Kim S, Ades M, Pinho V, Cournos F, McKinnon K. Patterns of HIV and mental health service integration in New York State. AIDS care. 2014 Aug 3;26(8):1027-31.

6. Munsami A, Gouse H, Nightingale S, Joska JA. HIV-Associated Neurocognitive Impairment Knowledge and Current Practices: A Survey of Frontline Healthcare Workers in South Africa. Journal of Community Health. 2020 Jul 29:1-7.

7. Liboro RM, Ibañez-Carrasco F, Rourke SB, Eaton A, Medina C, Pugh D, Rae A, Ross LE, Shuper PA. Barriers to addressing HIV-associated neurocognitive disorder (hand): community-based service provider perspectives. Journal of HIV/AIDS & Social Services. 2018 Jul 3;17(3):209-23.

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Reviewer #1: No

Reviewer #2: No

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Quality of life in people living with HIV-associated neurocognitive disorder: A scoping review

PONE-D-21-03610R1

Dear Dr. Alford,

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Kind regards,

Simone Reppermund, PhD

Academic Editor

PLOS ONE

Reviewers' comments: