Does highly active antiretroviral therapy improve neurocognitive function? A systematic review

Area of Science:

• Neuroscience
• Virology
• Psychology

Background:

• Highly active antiretroviral therapy (HAART) has impacted the incidence and prevalence of human immunodeficiency virus (HIV) dementia (HAD).
• Diagnostic criteria for HAD have evolved, emphasizing neurocognitive deficits.
• Standardized methods for assessing neuropsychological impairment are crucial for comparative research.

Purpose of the Study:

• To systematically review studies on the neurocognitive effects of initiating HAART.
• To evaluate the impact of HAART on neurocognitive and neuropsychological profiles in individuals with HIV.
• To identify limitations in current research methodologies for assessing HIV-associated neurocognitive disorders (HANDs).

Main Methods:

• Systematic review of single-cohort prospective treatment effect studies.
• Inclusion of studies reporting on neurocognitive or neuropsychological profiles of individuals starting HAART.
• Exclusion of observational or cross-sectional studies lacking within-subject pre- and post-HAART comparisons.

Main Results:

• Eleven of the fifteen included studies reported significant improvements in neurocognitive status after initiating HAART.
• Improvements were observed over an average study period of six months.
• HAART appears to improve cognition but does not completely eliminate impairments.

Conclusions:

• HAART demonstrates a positive effect on cognitive function in individuals with HIV.
• Current research methods vary widely, hindering cross-study comparisons.
• Further research with uniform methodologies is needed to understand the long-term effects of HAART on HANDs, including clear reporting of treatment regimens.