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HIV-1 infection and cognitive impairment in the cART-era: a review.

Journal article
Authors Judith Schouten
Paola Cinque
Magnus Gisslén
Peter Reiss
Peter Portegies
Published in AIDS
Volume 25
Issue 5
Pages 561-575
ISSN 1473-5571
Publication year 2011
Published at Institute of Biomedicine, Department of Infectious Medicine
Pages 561-575
Language en
Links dx.doi.org/10.1097/QAD.0b013e328343...
Keywords cART-era, cognitive impairment, HIV-1
Subject categories Microbiology in the medical area

Abstract

With the introduction of combination antiretroviral therapy (cART) AIDS dementia complex (ADC) or HIV-associated dementia (HAD), as it was termed later, largely disappeared in clinical practice. However, in the past few years, patients, long-term infected and treated, including those with systemically well-controlled infection, started to complain about milder memory problems and slowness, difficulties in concentration, planning, and multitasking.Neuropsychological studies have confirmed that cognitive impairment occurs in a substantial (15-50%) proportion of patients.Among HIV-1-infected patients cognitive impairment was and is one of the most feared complications of HIV-1-infection. In addition, neurocognitive impairment may affect adherence to treatment and ultimately result in increased morbidity for systemic disease.So what may be going on in the CNS after so many years of apparently controlled HIV-1-infection is an urgent and important challenge in the field of HIV-medicine.In this review we summarize the key currently available data. We describe the clinical neurological and neuropsychological findings, the preferred diagnostic approach with new imaging techniques and CSF-analysis. We try to integrate data on pathogenesis and finally discuss possible therapeutic interventions.

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