Update on neurological complications of HIV

Abstract

Purpose of review: The prevalence of neurological complications among people with HIV (PWH) is expected to increase as PWH live longer due to increased access to antiretroviral treatment (ART). This review provides updates to the understanding of the neurological sequelae, including neurocognitive impairment, neuropathy, neurological opportunistic infections, and others, which are crucial for improving care and outcomes of PWH.

Recent findings: Recent literature highlights several key themes: the pathophysiology of HIV-related neuronal damage involving HIV proteins (gp120, Nef) and neuroinflammation; the role of aging in exacerbating neurological complications; the high prevalence of HIV-associated neurocognitive disorders (HAND) and Alzheimer's disease-related dementias (AD/ADRD) among PWH; the importance of neurocognitive screening tools like IHDS and MoCA; and the identification of biomarkers and neuroimaging techniques for early detection and monitoring of HAND.

Summary: The findings highlight the need for comprehensive healthcare strategies to manage neurological complications in PWH, including targeted interventions for high-risk groups, improved diagnostic tools, and tailored treatments. It is important for clinicians and researchers to develop effective approaches to mitigate the impact of HIV on brain health and improve quality of life for PWH.

Keywords: HIV-associated neurocognitive disorder; HIV-associated neuropathy; central nervous system opportunistic infection; neurological complications HIV; people with HIV.