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Review
. 2013 Oct;13(10):387.
doi: 10.1007/s11910-013-0387-7.

Update on HIV-associated neurocognitive disorders

Tariq B Alfahad  1 , Avindra Nath
Affiliations
Review

Update on HIV-associated neurocognitive disorders

Tariq B Alfahad et al. Curr Neurol Neurosci Rep. 2013 Oct.

Abstract

Neurocognitive disorders are a feared complication of HIV infection, especially in the post-antiretroviral era as patients are living longer. These disorders are challenging in terms of diagnosis and treatment. The clinical syndrome has evolved, driven in part by comorbidities such as aging, drug abuse, psychiatric illnesses, and a metabolic syndrome associated with the use of antiretroviral drugs. Additionally some individuals may develop a fulminant immune reconstitution syndrome. Hence, treatment of these patients needs to be individualized. The focus of research in the HIV field has recently switched towards elimination of the HIV reservoir as a means of combating long-term HIV complications. However, these approaches may be suitable for limited populations and might not be applicable once the HIV reservoir has been established in the brain. Further, all clinical trials using neuroprotective or anti-inflammatory drugs for treatment of HIV-associated neurocognitive disorders have been unsuccessful. Hence, neurological complications of HIV infection are the biggest challenge facing HIV researchers, and there is a critical need to develop new diagnostics and approaches for treatment of these disorders.

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Figures

Figure 1
Figure 1
Magnetic resonance imaging of the brain from a 56 yr old patient with advanced HIV dementia. (A) This FLAIR sequence shows diffuse periventricular white matter high signal intensity lesions. (B) This shows enlargement of the ventricles and cortical atrophy.
Figure 2
Figure 2
Risk factors for HIV-associated neurocognitive disorders
See this image and copyright information in PMC

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