title: HIV-associated neurocognitive disease: case studies and suggestions for diagnosis and management in different patient subgroups.
abstract: The incidence of HIV-associated dementia has decreased significantly with the introduction of combination antiretroviral therapy; however, milder or more subtle forms of neurocognitive disorders associated with HIV appear to remain common. There is a lack of consensus on when to screen and on which methods are most appropriate for identifying patients at risk of neurocognitive impairment. Multiple factors (demographic, social, genetic, psychological and medical) can play a role in its aetiology and progression, including potential central nervous system toxicity of antiviral therapy. It is important to identify these factors in order to apply relevant management strategies. In this review, we discuss a series of case studies that address some of the challenges presented by the diagnosis and management of HIV-associated neurocognitive impairment in different patient types.
authors.affiliation: Chelsea & Westminster Hospital, London, UK. anton.pozniak@chelwest.nhs.uk.
authors.forename: Anton
authors.initials: A
authors.lastname: Pozniak
authors.forename: Simon
authors.initials: S
authors.lastname: Rackstraw
authors.forename: Jane
authors.initials: J
authors.lastname: Deayton
authors.forename: Tristan
authors.initials: T
authors.lastname: Barber
authors.forename: Steve
authors.initials: S
authors.lastname: Taylor
authors.forename: Hadi
authors.initials: H
authors.lastname: Manji
authors.forename: Diane
authors.initials: D
authors.lastname: Melvin
authors.forename: Michelle
authors.initials: M
authors.lastname: Croston
authors.forename: Sam
authors.initials: S
authors.lastname: Nightingale
authors.forename: Ranubabu
authors.initials: R
authors.lastname: Kulasegaram
authors.forename: Mervi
authors.initials: M
authors.lastname: Pitkanen
authors.forename: Alan
authors.initials: A
authors.lastname: Winston
mesh_terms: D015526:AIDS Dementia Complex / Q000175:diagnosis / Q000628:therapy; D023241:Antiretroviral Therapy, Highly Active; D003072:Cognition Disorders / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D012307:Risk Factors