A modern view on the prevention and treatment of HIV-associated neurocognitive disorders

Abstract

Acquired Immune Deficiency Syndrome (AIDS) is now considered one of the most global pandemics in human history. Despite the use of highly active antiretroviral therapy (HAART), HIV-1 infection is often accompanied by the development of CNS disorders, including neurocognitive disorders. The use of etiologic therapy has successfully prevented many of the possible terminal complications of the disease, but as patient survival time increases, the prevalence of cognitive impairment among AIDS patients is increasing. Theclinical manifestations of these disorders can rapidly progress from subtle attention deficits and behavioral disorders to the development of dementia. Diagnosing neurocognitive impairment in HIV-infected patients is usually difficult and requires consistent diagnostic procedures from the clinician, including initial screening and, if necessary, neuropsychiatric testing and neuroimaging. Early diagnosis and correction of neurocognitive impairment in HIV-infected individuals with adequate antiretroviral therapy is essential for successful treatment. The review also considers the use of drugs for the prevention and treatment of neurocognitive impairment, taking into account the peculiarities of persistence of the pathogen in the nervous system and the capabilities of modern medicine. One of the most promising methods of supporting therapy for such disorders is the delivery of antiretroviral drugs using various nanosystems (polymeric nanoparticles, lipid nanoparticles, nanogels, magnetic particles).