Assessment, Diagnosis, and Treatment of HIV-Associated Neurocognitive Disorder: A Consensus Report of the Mind Exchange Program

Antinori, Andrea; Arendt, Gabriele; Grant, Igor; Letendre, Scott; Muñoz-Moreno, José A.; Eggers, Christian; Brew, Bruce J.; Brouillette, Marie‐Josée; Bernal-Cano, Francisco; Carvalhal, Adriana; Christo, Paulo Pereira; Cinque, Paola; Cysique, Lucette A.; Ellis, Ronald J.; Everall, Ian; Grill, Jacques; Husstedt, Ingo W.; Korten, Volkan; Machala, Ladislav; Obermann, Mark; Ouakinin, Sílvia; Podzamczer, Daniel; Portegies, Peter; Rackstraw, Simon; Rourke, Sean B.; Sherr, Lorraine; Streinu-Cercel, Adrian; Winston, Alan; Wojna, Valerie; Yazdanpannah, Yazdan; Arbess, Gordon; Baril, Jean-Guy; Begovać, Josip; Bergin, Colm; Bonfanti, Paolo; Bonora, Stefano; Brinkman, Kees; Canestri, Ana; Cholewińska-Szymańska, Graźyna; Chowers, Michal; Cooney, John; Corti, Marcelo; Doherty, Colin; Elbirt, Daniel; Eßer, Stefan; Florence, Éric; Force, Gilles; Gill, John; Goffard, Jean-Christophe; Harrer, Thomas; Li, Patrick; Kerckhove, Linos Van de; Knecht, Gaby; Matsushita, Shuzo; Matulionytė, Raimonda; McConkey, Samuel; Mouglignier, Antoine; Oka, Shinichi; Penalva, Augusto; Riesenberg, Klaris; Sambatakou, Helen; Tozzi, Valerio; Vassallo, Mattéo; Wetterberg, Peter; Drapato, Alicia Wiercińska

doi:10.1093/cid/cis975

Cited by 171 publications

(143 citation statements)

References 91 publications

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“…Moreover, the potential neurotoxic adverse effects of cART may mitigate some of its anticipated benefits (Price and Spudich 2008; Cysique et al 2011; Group 2013). Thus, a likely consequence of cART initiation is to effectively tilt the observed baseline association between plasma HIV RNA and cognitive function towards the null.…”

Section: Discussionmentioning

confidence: 99%

Plasma HIV RNA level is associated with neurocognitive function among HIV-1-infected patients in Nigeria

et al. 2018

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Plasma HIV RNA level has been shown to correlate with HIV disease progression, morbidity and mortality. We examined the association between levels of plasma HIV RNA and cognitive function among patients in Nigeria. A total of 179 HIV-1 infected participants with available plasma HIV RNA results and followed longitudinally for up to 2 years were included in this study. Blood samples from participants were used for the measurement of plasma HIV RNA and CD4+ T cell count. Utilizing demographic and practice effect adjusted T scores obtained from a 7-domain neuropsychological test battery, cognitive status was determined by the global deficit score (GDS) approach, with a GDS ≥ 0.5 indicating cognitive impairment. In a longitudinal multivariable linear regression analysis, adjusting for CD4 cell count, Beck’s depression score, age, gender, years of education, and antiretroviral treatment status, global T scores decreased by 0.35 per log10 increase in Plasma HIV RNA [p=0.033]. Adjusting for the same variables in a multivariable logistic regression, the odds of neurocognitive impairment were 28% higher per log10 increase in plasma HIV RNA (OR: 1.28 [95% CI: 1.08, 1.51]; p=0.005). There were statistically significant associations for the speed of information processing, executive and verbal fluency domains in both linear and logistic regression analyses. We found a significant association between plasma HIV RNA levels and cognitive function in both baseline (cross-sectional) and longitudinal analyses. However, the latter was significantly attenuated due to weak association among antiretroviral-treated individuals.

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Section: Discussionmentioning

confidence: 99%

Plasma HIV RNA level is associated with neurocognitive function among HIV-1-infected patients in Nigeria

et al. 2018

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“…14 Potential contributing factors, such as reversible endocrine disturbances, nutritional deficiencies, and others must be explored, and in some instances the roles of cerebrovascular disease or neurodegenerative disorders such as Alzheimer’s disease (AD) need to be considered. Other disorders known to have an impact on cognitive functions (e.g., hepatitis C virus coinfection, substance abuse) may interact with age as well.…”

Section: Hiv and Abnormal Aging: Convergent Pathophysiological Mechanmentioning

confidence: 99%

HIV and Aging: Effects on the Central Nervous System

2014

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With the introduction of combination antiretroviral therapy, many human immunodeficiency virus-positive (HIV+) individuals are reaching advanced age. The proportion of people living with HIV older than 50 years already exceeds 50% in many communities, and is expected to reach this level nationally by 2015. HIV and aging are independently associated with neuropathological changes, but their concurrence may have a more deleterious effect on the central nervous system (CNS). Published data about neurocognitive and neuroimaging markers of HIV and aging are reviewed. Putative factors contributing to neurocognitive impairment and neuroimaging changes in the aging HIV+ brain, such as metabolic disturbances, cardiovascular risk factors, immune senescence, and neuroinflammation, are described. The possible relationship between HIV and some markers of Alzheimer’s disease is presented. Current research findings emphasize multiple mechanisms related to HIV and combination antiretroviral therapy that compromise CNS structure and function with advancing age.

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“…The brain is one of the first targets of HIV-1; thus, clinical assessment of neurocognitive function is recommended for all HIV-1 positive patients regardless of symptoms or patient risk factors for HAND (Mind Exchange Working 2013). A presumptive clinical diagnosis of HAND is indicated when there is evidence of an acquired difficulty with everyday functioning as determined by questionnaires and other screening tools (Vance, McDougall et al 2014).…”

Section: Introductionmentioning

confidence: 99%

The HIV-1 transgenic rat model of neuroHIV

Vigorito

Connaghan

Chang

2015

Brain, Behavior, and Immunity

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Despite the ability of current combination anti-retroviral therapy (cART) to limit the progression of HIV-1 to AIDS, HIV-positive individuals continue to experience neuroHIV in the form of HIV-associated neurological disorders (HAND), which can range from subtle to substantial neurocognitive impairment. NeuroHIV may also influence substance use, abuse, and dependence in HIV-positive individuals. Because of the nature of the virus, variables such as mental health co-morbidities make it difficult to study the interaction between HIV and substance abuse in human populations. Several rodent models have been developed in an attempt to study the transmission and pathogenesis of the HIV-1 virus. The HIV-1 transgenic (HIV-1Tg) rat is a reliable model of neuroHIV because it mimics the condition of HIV-infected patients on cART. Research using this model supports the hypothesis that the presence of HIV-1 viral proteins in the central nervous system increases the sensitivity and susceptibility of HIV-positive individuals to substance abuse.

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Assessment, Diagnosis, and Treatment of HIV-Associated Neurocognitive Disorder: A Consensus Report of the Mind Exchange Program

Cited by 171 publications

References 91 publications

Plasma HIV RNA level is associated with neurocognitive function among HIV-1-infected patients in Nigeria

Plasma HIV RNA level is associated with neurocognitive function among HIV-1-infected patients in Nigeria

HIV and Aging: Effects on the Central Nervous System

The HIV-1 transgenic rat model of neuroHIV

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