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Review
. 2025 Feb 1;38(1):37-43.
doi: 10.1097/QCO.0000000000001080. Epub 2024 Dec 6.

Risk factors for cognitive decline in persons with HIV

Merle Henderson  1   2 , Alan Winston  1   2
Affiliations
Review

Risk factors for cognitive decline in persons with HIV

Merle Henderson et al. Curr Opin Infect Dis. .

Abstract

Purpose of review: Cognitive disorders persist in persons with HIV, despite virologically suppressive antiretroviral therapy. We summarize the current evidence on risk factors for cognitive decline in persons with HIV in the modern antiretroviral therapy-era.

Recent findings: Recent consensus recommendations have proposed a new approach for defining cognitive impairment in persons with HIV, which distinguishes true cognitive impairment from low cognitive performance alone and considers both HIV and non-HIV-associated causes of brain injury. Adverse mental health, risks associated with substance misuse, and an increasing burden of age-related comorbidities have been highlighted as important contributors toward cognitive decline in this population. Aging may potentiate these risk factors through polypharmacy and drug-drug interactions.

Summary: Cognitive decline in persons with HIV is likely multifactorial, with contributions from both HIV and non-HIV-associated mechanisms, particularly age-related comorbidities. With an aging community of persons with HIV, screening for risk factors associated with cognitive decline may be crucial to implement appropriate risk reduction strategies.

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Conflict of interest statement

Nil to disclose.

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References

    1. Navia BA, Jordan BD, Price RW. The AIDS dementia complex: I. Clinical features. Ann Neurol 1986; 19:517–524. - PubMed
    1. Mastrorosa I, Pinnetti C, Brita AC, et al. . Declining prevalence of human immunodeficiency virus (HIV)–associated neurocognitive disorders in recent years and associated factors in a large cohort of antiretroviral therapy–treated individuals with HIV. Clin Infect Dis 2023; 76:e629–e637. - PMC - PubMed
    1. Alford K, Banerjee S, Daley S, et al. . Health-related quality of life in people living with HIV with cognitive symptoms: assessing relevant domains and associations. J Int Assoc Provid AIDS Care 2023; 22:23259582231164241. - PMC - PubMed
    1. Underwood J, Robertson KR, Winston A. Could antiretroviral neurotoxicity play a role in the pathogenesis of cognitive impairment in treated HIV disease? AIDS 2015; 29:253–261. - PubMed
    1. Qu Y, Weinstein A, Wang Z, et al. . Legacy effect on neuropsychological function in HIV-infected men on combination antiretroviral therapy. AIDS 2022; 36:19–27. - PMC - PubMed

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