ePrints

Recent advances in HIV-associated neurocognitive disorders: A focus on older adults and sub-Saharan Africa

Lookup NU author(s): Dr Stella Paddick, Dr Elizabeta Mukaetova-Ladinska

Downloads

Full text for this publication is not currently held within this repository. Alternative links are provided below where available.

Abstract

© 2024 Lippincott Williams and Wilkins. All rights reserved.Purpose of reviewWe reviewed recent literature on prevalence and interventional approaches for cognitive impairment in the context of HIV infection alongside current controversies and challenges around its nomenclature, screening, and diagnosis.Recent findingsPrevalence estimates for HIV-associated neurocognitive disorder (HAND) indicate that HAND remains highly prevalent despite combination antiretroviral treatment (cART) widely used. The available data are heterogeneous, particularly in sub-Saharan Africa (SSA) where recent reviews indicate substantial heterogeneity, wide prevalence estimates and lack of data from the majority SSA countries, despite them currently experiencing the greatest burden worldwide of both HIV and HAND.Several alternative approaches to diagnosis and classification of cognitive impairment in HIV have been published, taking into account changing clinical phenotypes.SummaryCognitive impairment remains a significant challenge in the care of people living with HIV despite advances in treatment. Ongoing controversies exist around nomenclature and classification, screening measures, and the phenotype and aetiology of observed impairments. Two current areas of research priority and focus include understanding current phenotypes of individuals living and ageing with treated HIV and differing levels of risk for HAND in these phenotypes, alongside the effects of commonly occurring comorbidities.The current evidence base for interventional approaches is limited, but growing. The most promising avenues appear to be multidisciplinary. These are currently focussed on high income settings rather than SSA where the majority of people living with HIV, and affected by cognitive impairment in the context of HIV, currently reside.

Publication metadata

Author(s): Paddick S-M, Mukaetova-Ladinska EB

Publication type: Review

Publication status: Published

Journal: Current Opinion in Psychiatry

Year: 2024

Volume: 37

Issue: 2

Pages: 87-93

Online publication date: 01/03/2024

Acceptance date: 02/04/2018

ISSN (print): 0951-7367

ISSN (electronic): 1473-6578

Publisher: Lippincott Williams and Wilkins

URL: https://doi.org/10.1097/YCO.0000000000000919

DOI: 10.1097/YCO.0000000000000919

PubMed id: 38226543

Share