Neuropsychological functioning and antiretroviral treatment in HIV/AIDS: a review.
This article presents a review of studies that have investigated the neuropsychological effects of antiretroviral treatment (ART) for HIV-1 infection. It provides a brief overview of the era of monotherapy, dual-therapy, and an extended overview of the current era of combination antiretroviral therapy (CART). This review highlights that while CART has had a dramatic effect on the incidence and the severity of HIV-associated neurocognitive disorders (HAND), HAND, in its mild form, still remains prevalent. New causes of this sustained prevalence are poor CNS penetration of some antiretroviral agents, drug resistance, poor adherence, potential neurotoxicity, co-morbidities such as the long-term CART side effects in relation to cardio-vascular disease, and chronic HIV brain infection that may facilitate the expression of new forms of neurodegenerative processes. The review emphasizes the need to address methodological limitations of published studies and the need for large and representative cross-disciplinary longitudinal investigations across the HIV illness span.
Brain Sciences, University of New South Wales, and Department of Neurology, Xavier Building, Level 4, St. Vincent's Hospital, 390 Victoria Street, Sydney, NSW, 2010, Australia. lcysique@unsw.edu.au
Lucette A
LA
Cysique
Bruce J
BJ
Brew
D015526:AIDS Dementia Complex / Q000517:prevention & control; D000163:Acquired Immunodeficiency Syndrome / Q000150:complications / Q000188:drug therapy*; D044966:Anti-Retroviral Agents / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active / Q000379:methods*; D002493:Central Nervous System Diseases / Q000209:etiology / Q000517:prevention & control* / Q000821:virology; D003072:Cognition Disorders / Q000209:etiology / Q000517:prevention & control* / Q000821:virology; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D009483:Neuropsychological Tests
D044966:Anti-Retroviral Agents