Controversies in HIV-associated neurocognitive disorders
- PMID: 25316020
- PMCID: PMC4313542
- DOI: 10.1016/S1474-4422(14)70137-1
Controversies in HIV-associated neurocognitive disorders
Abstract
Cross-sectional studies show that around half of individuals infected with HIV-1 have some degree of cognitive impairment despite the use of antiretroviral drugs. However, prevalence estimates vary depending on the population and methods used to assess cognitive impairment. Whether asymptomatic patients would benefit from routine screening for cognitive difficulties is unclear and the appropriate screening method and subsequent management is the subject of debate. In some patients, HIV-1 RNA can be found at higher concentrations in CSF than in blood, which potentially results from the poor distribution of antiretroviral drugs into the CNS. However, the clinical relevance of so-called CSF viral escape is not well understood. The extent to which antiretroviral drug distribution and toxicity in the CNS affect clinical decision making is also debated.
Copyright © 2014 Elsevier Ltd. All rights reserved.
Figures



Similar articles
-
Relation of cerebrospinal fluid/plasma HIV-RNA discordance with neurocognitive impairment.Natl Med J India. 2015 Sep-Oct;28(5):228-32. Natl Med J India. 2015. PMID: 27132951
-
Evaluation of HIV RNA and markers of immune activation as predictors of HIV-associated dementia.Neurology. 2004 Dec 14;63(11):2084-90. doi: 10.1212/01.wnl.0000145763.68284.15. Neurology. 2004. PMID: 15596754
-
HIV-associated neurocognitive disorder.Handb Clin Neurol. 2018;152:75-97. doi: 10.1016/B978-0-444-63849-6.00007-4. Handb Clin Neurol. 2018. PMID: 29604986 Review.
-
HIV-associated neurocognitive disease: case studies and suggestions for diagnosis and management in different patient subgroups.Antivir Ther. 2014;19(1):1-13. doi: 10.3851/IMP2563. Epub 2013 Mar 21. Antivir Ther. 2014. PMID: 23519006 Review.
-
Guidelines for Evaluation and Management of Cognitive Disorders in HIV-Positive Individuals.Curr HIV/AIDS Rep. 2016 Oct;13(5):235-40. doi: 10.1007/s11904-016-0324-x. Curr HIV/AIDS Rep. 2016. PMID: 27353598 Free PMC article. Review.
Cited by 100 articles
-
Machine learning prediction of neurocognitive impairment among people with HIV using clinical and multimodal magnetic resonance imaging data.J Neurovirol. 2021 Feb;27(1):1-11. doi: 10.1007/s13365-020-00930-4. Epub 2021 Jan 19. J Neurovirol. 2021. PMID: 33464541
-
Association of Immunosuppression and Viral Load With Subcortical Brain Volume in an International Sample of People Living With HIV.JAMA Netw Open. 2021 Jan 4;4(1):e2031190. doi: 10.1001/jamanetworkopen.2020.31190. JAMA Netw Open. 2021. PMID: 33449093 Free PMC article.
-
Brain Disease Network Analysis to Elucidate the Neurological Manifestations of COVID-19.Mol Neurobiol. 2021 Jan 6:1-19. doi: 10.1007/s12035-020-02266-w. Online ahead of print. Mol Neurobiol. 2021. PMID: 33409839 Free PMC article.
-
Sex Differences in the Patterns and Predictors of Cognitive Function in HIV.Front Neurol. 2020 Nov 23;11:551921. doi: 10.3389/fneur.2020.551921. eCollection 2020. Front Neurol. 2020. PMID: 33329301 Free PMC article.
-
Comparative analysis of human microglial models for studies of HIV replication and pathogenesis.Retrovirology. 2020 Nov 19;17(1):35. doi: 10.1186/s12977-020-00544-y. Retrovirology. 2020. PMID: 33213476 Free PMC article.
Publication types
MeSH terms
Substances
Grant support
LinkOut - more resources
Full Text Sources
Other Literature Sources
Medical