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A Rat Model of EcoHIV Brain Infection
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HIV and neurocognitive dysfunction.

Serena Spudich1

  • 1Department of Neurology, Yale University, 300 George Street, Room 8300c, New Haven, CT 06510, USA. serena.spudich@yale.edu

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Effective antiretroviral therapy (ART) has shifted HIV-associated neurocognitive disorder (HAND) from dementia to milder cognitive issues. Neurologic injury persists despite ART, posing challenges for long-term HIV management and quality of life.

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Area of Science:

  • Neuroscience
  • Infectious Diseases
  • Public Health

Background:

  • Effective antiretroviral therapy (ART) has transformed HIV/AIDS care.
  • HIV-associated neurocognitive disorder (HAND) presentation has shifted due to ART.
  • Subtle cognitive impairments persist in long-term treated HIV survivors.

Purpose of the Study:

  • To describe the altered spectrum of HAND in the era of effective ART.
  • To identify challenges in managing persistent neurologic injury despite ART.
  • To explore potential causes of ongoing cognitive dysfunction in treated HIV.

Main Methods:

  • Review of current literature on HAND and ART.
  • Analysis of clinical observations regarding HAND presentation.
  • Discussion of factors contributing to persistent neurocognitive deficits.

Main Results:

  • HAND now typically presents as milder cognitive impairment, not dementia.
  • Neurologic injury and cognitive dysfunction persist in individuals on ART.
  • Potential causes include pre-ART CNS injury, ongoing low-level infection, or comorbidities.

Conclusions:

  • ART has improved HAND severity but not eliminated it.
  • Persistent neurologic injury despite ART remains a significant clinical challenge.
  • Optimizing quality of life for HIV survivors requires addressing persistent cognitive issues.