HIV-Associated Neurocognitive Disorders: A Global Perspective.

Area of Science:

• Neuroscience
• Infectious Diseases
• Global Health

Background:

• HIV-associated neurocognitive disorders (HAND) research has evolved since the 2007 nomenclature.
• Prevalence rates and neuropsychological (NP) profiles of HAND remain areas of ongoing investigation.
• Global expansion of NeuroHIV research is crucial, especially in high HIV burden regions.

Purpose of the Study:

• To provide a worldwide overview of HAND research, focusing on prevalence and NP profiles.
• To assess current controversies and propose solutions for advancing HAND research.
• To compare NP profiles in non-Western and Western HIV+ cohorts.

Main Methods:

• Review of global studies on HAND prevalence and NP profiles since 2007.
• Cross-sectional analysis of NP profiles in diverse HIV+ cohorts.
• Review of longitudinal NP studies in HIV+ cohorts.

Main Results:

• Similar HAND rates observed globally, irrespective of treatment status, compared to high-income countries.
• Persons with chronic HIV infection and past immunosuppression are most at risk globally.
• Early treated, virally suppressed individuals represent a minority of those at risk.

Conclusions:

• Global NP studies in HIV infection have successfully expanded to diverse, low- to medium-income countries.
• Longitudinal designs are vital for understanding asymptomatic neurocognitive impairment and biomarker discovery.
• Harmonization of methods and data across global studies is essential for advancing HAND research.