title: Updated research nosology for HIV-associated neurocognitive disorders.
abstract: 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.
authors.affiliation: Clinical Department, National Institute for Infectious Diseases Lazzaro Spallanzani, Instituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Antinori
authors.forename: G
authors.initials: G
authors.lastname: Arendt
authors.forename: J T
authors.initials: JT
authors.lastname: Becker
authors.forename: B J
authors.initials: BJ
authors.lastname: Brew
authors.forename: D A
authors.initials: DA
authors.lastname: Byrd
authors.forename: M
authors.initials: M
authors.lastname: Cherner
authors.forename: D B
authors.initials: DB
authors.lastname: Clifford
authors.forename: P
authors.initials: P
authors.lastname: Cinque
authors.forename: L G
authors.initials: LG
authors.lastname: Epstein
authors.forename: K
authors.initials: K
authors.lastname: Goodkin
authors.forename: M
authors.initials: M
authors.lastname: Gisslen
authors.forename: I
authors.initials: I
authors.lastname: Grant
authors.forename: R K
authors.initials: RK
authors.lastname: Heaton
authors.forename: J
authors.initials: J
authors.lastname: Joseph
authors.forename: K
authors.initials: K
authors.lastname: Marder
authors.forename: C M
authors.initials: CM
authors.lastname: Marra
authors.forename: J C
authors.initials: JC
authors.lastname: McArthur
authors.forename: M
authors.initials: M
authors.lastname: Nunn
authors.forename: R W
authors.initials: RW
authors.lastname: Price
authors.forename: L
authors.initials: L
authors.lastname: Pulliam
authors.forename: K R
authors.initials: KR
authors.lastname: Robertson
authors.forename: N
authors.initials: N
authors.lastname: Sacktor
authors.forename: V
authors.initials: V
authors.lastname: Valcour
authors.forename: V E
authors.initials: VE
authors.lastname: Wojna
mesh_terms: 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