Screening for cognitive impairment in human immunodeficiency virus

Area of Science:

• Neuroscience
• Infectious Diseases
• Geriatrics

Background:

• Human Immunodeficiency Virus (HIV)-associated neurocognitive disorders (HAND) are highly prevalent, exceeding 50% and increasing in aging populations.
• Cognitive impairment in HIV can affect treatment adherence and is linked to mortality, underscoring the need for early detection.
• Current screening methods for HAND are insufficient, with HIV-specific tools performing poorly for milder forms of impairment.

Purpose of the Study:

• To review the clinical presentation of HAND.
• To evaluate existing screening tools for HAND.
• To provide preliminary recommendations for HAND screening in aging HIV-positive individuals.

Main Methods:

• Review of existing literature on HAND prevalence and screening tools.
• Analysis of the performance characteristics of current HAND screening methods.
• Clinical description of HAND presentation.

Main Results:

• Most HIV-specific screening tools are inadequate for detecting the majority of HAND cases.
• Symptom-based detection of HAND is unreliable due to poor patient insight and confounding factors.
• Broader screening approaches are needed for the aging HIV-positive population to identify both HAND and other neurodegenerative disorders.

Conclusions:

• There is a critical need for improved and broader screening tools for HAND.
• Current methods fail to adequately identify individuals with HAND, especially milder forms.
• Preliminary recommendations are provided in the absence of definitive screening guidelines.