HIV-associated neurocognitive disorder

HIV-associated neurocognitive disorder (HAND) is a condition characterized by cognitive, motor and behavioral impairments directly caused by HIV infection. It is a common neurological complication in individuals with HIV, affecting approximately 50% of patients, despite the use of antiretroviral therapy (ART).

Etiology

The exact cause of HAND is not fully understood. However, it is believed to be a result of direct effects of HIV on the central nervous system (CNS), as well as indirect effects such as immune activation and inflammation. HIV can enter the CNS early after infection, leading to neuronal damage and dysfunction.

Clinical Presentation

HAND can present with a wide range of symptoms, from asymptomatic neurocognitive impairment (ANI) to minor neurocognitive disorder (MND) and HIV-associated dementia (HAD). Symptoms can include cognitive impairments such as memory loss, difficulty concentrating, and slowed information processing, as well as motor symptoms such as clumsiness and poor balance.

Diagnosis

Diagnosis of HAND is based on clinical assessment, including neuropsychological testing, as well as ruling out other potential causes of neurocognitive impairment. Neuroimaging techniques such as magnetic resonance imaging (MRI) and positron emission tomography (PET) can also be used to assess brain abnormalities.

Treatment

There is currently no cure for HAND. However, treatment is focused on managing symptoms and slowing disease progression. This typically involves the use of ART to control HIV infection, as well as supportive therapies such as cognitive rehabilitation and physical therapy.

Prognosis

The prognosis for individuals with HAND varies widely, depending on factors such as the severity of symptoms, the individual's overall health, and their response to treatment. However, with appropriate management, many individuals with HAND can lead productive lives.

See Also

• HIV/AIDS
• Neurocognitive disorder
• Antiretroviral therapy