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HIV-associated neurocognitive disorders (HAND) are common, even with treatment. Diagnosis requires neuropsychological testing, and factors like HIV clade and comorbidities influence cognitive dysfunction.

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Area of Science:

  • Neuroscience
  • Infectious Diseases
  • Public Health

Background:

  • HIV-associated neurocognitive disorders (HAND) are a significant cause of cognitive impairment.
  • Milder forms, asymptomatic neurocognitive impairment (ANI) and mild neurocognitive disorder (MND), are prevalent despite combined antiretroviral therapy (cART).

Purpose of the Study:

  • To review current understanding of HAND diagnosis and management.
  • To highlight factors influencing HAND, including cART CNS penetration and HIV clade.
  • To emphasize the role of comorbidities in cognitive dysfunction.

Main Methods:

  • Review of existing literature on HAND.
  • Discussion of diagnostic criteria and treatment considerations.
  • Analysis of factors affecting HAND prevalence and severity.

Main Results:

  • ANI and MND are highly prevalent, necessitating neuropsychological testing for diagnosis.
  • The impact of cART CNS penetration on HAND prognosis requires further investigation.
  • Certain HIV clades and comorbidities are associated with increased risk of cognitive dysfunction.

Conclusions:

  • Accurate diagnosis of HAND, particularly milder forms, is crucial.
  • Treatment strategies should consider CNS penetration effectiveness and HIV subtype.
  • Management of comorbidities is essential for addressing cognitive dysfunction in HIV patients.