HIV-associated neurocognitive disorders

Abstract

Currently, neuropsychological impairment among HIV+ patients on antiretroviral therapy leads to a reduction in the quality of life and it is an important challenge due to the high prevalence of HIV-associated neurocognitive disorders and its concomitant consequences in relation to morbidity and mortality- including those HIV+ patients with adequate immunological and virological status. The fact that the virus is established in CNS in the early stages and its persistence within the CNS can help us to understand HIV-related brain injury even when highly active antiretroviral therapy is effective. The rising interest in HIV associated neurocognitive disorders has let to development new diagnostic tools, improvement of the neuropsychological tests, and the use of new biomarkers and new neuroimaging techniques that can help the diagnosis. Standardization and homogenization of neurocognitive tests as well as normalizing and simplification of easily accessible tools that can identify patients with increased risk of cognitive impairment represent an urgent requirement. Future efforts should also focus on diagnostic keys and searching for useful strategies in order to decrease HIV neurotoxicity within the CNS.

Diagnósticos de enfermagem e seus componentes em pacientes com a síndrome da imunodeficiência adquirida

“…(21,23) Additionally, HIV can contribute to the onset of neurologic manifestations, such as progressive dementia. (9,24) Consequently, it is unquestionable the need for the nursing practice to engage in efforts to also carry out health education activities directed towards promoting the practice of safer sex; protection against infection, by explaining the signs and symptoms of the infection, and ways of avoiding them; process/treatment, by explaining the purpose and how to participate in the treatment; and the illness process, by explaining the illness physiopathology, about their health condition and changes in lifestyle to avoid further complications and/or control of the illness process, as well as control measures related to the illness treatment side effects.…”

Joint Data Harmonization and Group Cardinality Constrained Classification

“…Distinguishing HAND from MCI is clinically challenging due to similarity in symptoms and missing standard protocols for assessing neuropsychological deficits [5]. Not only is our classifier indifferent to the controls from both groups but is also significantly more accurate in distinguishing the two diseases than the conventional sequential harmonization and classification approach and non-sparsity based logistic regression methods.…”

Neurological complication in HIV patients

“…Also, this syndrome may cause poor adherence to HIV care, job loss, adecline of driving ability, and lesser adherence with HIV medication, with increased morbidity and mortality. [7,11] In 2007, new criteria were published defining how to diagnosis HAND, including a wide spectrum of HIV related cognitive impairments, as follow:…”

“…HAD was significant impairment (loss of activities of daily living) and impairment in two or more neurophysiological symptoms and two or more standards deviation below the mean for matched controls. [8,11] The creation of very active antiretroviral therapy (HAART) as the essential HIV treatment has led to significant reduction in the prevalence of severe HIV-associated dementia (HAD) and central nervous system (CNS) opportunistic infection. [8,11] …”

“…[8,11] The creation of very active antiretroviral therapy (HAART) as the essential HIV treatment has led to significant reduction in the prevalence of severe HIV-associated dementia (HAD) and central nervous system (CNS) opportunistic infection. [8,11] …”