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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 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.
Immunocytochemical quantitation of human immunodeficiency virus in the brain: Correlations with dementia
It is concluded that the presence of macrophages and microglia is a better correlate with HIV‐associated dementia than is the presence and amount of HIV‐infected cells in the brain.
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.
The International HIV Dementia Scale: a new rapid screening test for HIV dementia
The IHDS may be a useful screening test to identify individuals at risk for HIV dementia in both the industrialized world and the developing world and full neuropsychological testing should be performed to confirm a diagnosis of HIV dementia.
HIV-associated neurocognitive disorder — pathogenesis and prospects for treatment
It is suggested that adjunctive therapies — treatments targeting CNS inflammation and other metabolic processes, including glutamate homeostasis, lipid and energy metabolism — are needed to reverse or improve HAND-related neurological dysfunction.
HIV Dementia Scale: a rapid screening test.
- C. Power, O. Selnes, J. Grim, J. McArthur
- Medicine, PsychologyJournal of acquired immune deficiency syndromes…
- 1 March 1995
The newly developed HIV Dementia Scale (HDS) is a reliable and quantitative scale that is superior to other widely used bedside tests such as the MMSE for identifying HIV dementia.
Induction of monocyte chemoattractant protein-1 in HIV-1 Tat-stimulated astrocytes and elevation in AIDS dementia.
- K. Conant, A. Garzino-Demo, E. Major
- BiologyProceedings of the National Academy of Sciences…
- 17 March 1998
It is shown that the HIV-1 transactivator protein Tat significantly increases astrocytic expression and release of monocyte chemoattractant protein-1 (MCP-1), which provides a potential link between the presence of HIV- 1 in the brain and the monocytic infiltration that may substantially contribute to dementia.
Human immunodeficiency virus‐associated neurocognitive disorders: Mind the gap
This review attempts to answer why there appears to be a therapeutic gap between the salutary effects of antiretroviral regimens and normalization of neurological function, and discusses the animal models that have helped to elucidate these mechanisms.