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Updated research nosology for HIV-associated neurocognitive disorders
This report reviews the collective experience with HIV-associated neurocognitive disorders (HAND), particularly since the advent of highly active antiretroviral treatment, and their definitional criteria; discusses the impact of comorbidities; and suggests inclusion of the term asymptomatic neuroc cognitive impairment to categorize individuals with subclinical impairment.
HIV-associated neurocognitive disorders persist in the era of potent antiretroviral therapy
The most severe HAND diagnosis (HAD) was rare, but milder forms of impairment remained common, even among those receiving CART who had minimal comorbidities.
HIV-associated neurocognitive disorders before and during the era of combination antiretroviral therapy: differences in rates, nature, and predictors
High rates of mild NCI persist at all stages of HIV infection, despite improved viral suppression and immune reconstitution with CART, and the consistent association of NCI with nadir CD4 across eras suggests that earlier treatment to prevent severe immunosuppression may also help prevent HAND.
Validation of the CNS Penetration-Effectiveness rank for quantifying antiretroviral penetration into the central nervous system.
Poorer penetration of ARV drugs into the CNS appears to allow continued HIV replication in the CNS as indicated by higher CSF HIV viral loads, which is probably critical in treating patients who have HIV-associated neurocognitive disorders.
Natalizumab-associated progressive multifocal leukoencephalopathy in patients with multiple sclerosis: lessons from 28 cases
Pharmacogenetics of efavirenz and central nervous system side effects: an Adult AIDS Clinical Trials Group study
A CYP2B6 allelic variant that is more common in African-Americans than in Europeans-Americans was associated with significantly greater efavirenz plasma exposure during HIV therapy, and inter-individual differences in metabolism may, in part, explain susceptibility to efvirenz central nervous system side effects.
Evaluation of patients treated with natalizumab for progressive multifocal leukoencephalopathy.
A detailed review of possible cases ofPML in patients exposed to natalizumab found no new cases and suggested a risk of PML of roughly 1 in 1000 patients treated with natalIZumab for a mean of 17.9 months.
HIV and Aging: State of Knowledge and Areas of Critical Need for Research. A Report to the NIH Office of AIDS Research by the HIV and Aging Working Group
- K. High, M. Brennan-Ing, P. Volberding
- MedicineJournal of acquired immune deficiency syndromes
- 1 July 2012
Critical resources are needed to enact this research agenda and include expanded review panel expertise in aging, functional measures, and multimorbidity, and facilitated use and continued funding to allow long-term follow-up of cohorts aging with HIV.
Progressive multifocal leukoencephalopathy and other forms of JC virus disease
- B. Brew, N. Davies, P. Cinque, D. Clifford, A. Nath
- Medicine, BiologyNature Reviews Neurology
- 1 December 2010
The controversies surrounding JCV infection are critically appraised, the practical management guidelines for PML are provided, and reconstitution of the immune system affords the best prognosis for this condition.
PML diagnostic criteria
Objective: To establish criteria for the diagnosis of progressive multifocal leukoencephalopathy (PML). Methods: We reviewed available literature to identify various diagnostic criteria employed.…