Updated research nosology for HIV-associated neurocognitive disorders.
In 1991, the AIDS Task Force of the American Academy of Neurology published nomenclature and research case definitions to guide the diagnosis of neurologic manifestations of HIV-1 infection. Now, 16 years later, the National Institute of Mental Health and the National Institute of Neurological Diseases and Stroke have charged a working group to critically review the adequacy and utility of these definitional criteria and to identify aspects that require updating. This report represents a majority view, and unanimity was not reached on all points. It reviews our collective experience with HIV-associated neurocognitive disorders (HAND), particularly since the advent of highly active antiretroviral treatment, and their definitional criteria; discusses the impact of comorbidities; and suggests inclusion of the term asymptomatic neurocognitive impairment to categorize individuals with subclinical impairment. An algorithm is proposed to assist in standardized diagnostic classification of HAND.
Antinori
A
A
Clinical Department, National Institute for Infectious Diseases Lazzaro Spallanzani, Instituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy.
Arendt
G
G
Becker
J T
JT
Brew
B J
BJ
Byrd
D A
DA
Cherner
M
M
Clifford
D B
DB
Cinque
P
P
Epstein
L G
LG
Goodkin
K
K
Gisslen
M
M
Grant
I
I
Heaton
R K
RK
Joseph
J
J
Marder
K
K
Marra
C M
CM
McArthur
J C
JC
Nunn
M
M
Price
R W
RW
Pulliam
L
L
Robertson
K R
KR
Sacktor
N
N
Valcour
V
V
Wojna
V E
VE
D015526:AIDS Dementia Complex / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology* / Q000628:therapy; D000047:Academies and Institutes; D000465:Algorithms; D023241:Antiretroviral Therapy, Highly Active; D003072:Cognition Disorders / Q000145:classification / Q000175:diagnosis / Q000209:etiology / Q000821:virology; D018450:Disease Progression; D015497:HIV-1; D006801:Humans; D009483:Neuropsychological Tests; D012106:Research