title: Screening for HIV-related neurocognitive impairment in clinical practice: challenges and opportunities.
abstract: With increasingly successful management of HIV, focus has shifted away from AIDS-related complications to other chronic co-morbidities. For HIV-related cognitive problems, the true aetiopathogenesis and epidemiology remains unclear. Rather than a systematic review, this paper presents the challenges and the opportunities we faced in establishing our own clinical service. Papers were identified using Pubmed and the terms "screening", "HIV" and "neurocognitive". This article covers the background of HIV-associated neurocognitive disorders (HAND) with a focus on HIV-related neurocognitive impairment (NCI), detailing classification, prevalence, diagnostic categories and diagnostic uncertainties. Screening is discussed, including a comparison of the available screening tools for cognitive deficits in HIV-infected patients and the importance of practice effects. Discussed also are the normal ranges and the lack thereof and potential investigations for those found to have impairments. We conclude by discussing the role of NCI screening in routine clinical care at the current time.
authors.affiliation: a St. Stephen's Centre , Chelsea and Westminster Hospital NHS Foundation Trust , London , UK.
authors.forename: T J
authors.initials: TJ
authors.lastname: Barber
authors.forename: D
authors.initials: D
authors.lastname: Bradshaw
authors.forename: D
authors.initials: D
authors.lastname: Hughes
authors.forename: L
authors.initials: L
authors.lastname: Leonidou
authors.forename: A
authors.initials: A
authors.lastname: Margetts
authors.forename: D
authors.initials: D
authors.lastname: Ratcliffe
authors.forename: S
authors.initials: S
authors.lastname: Thornton
authors.forename: A
authors.initials: A
authors.lastname: Pozniak
authors.forename: D
authors.initials: D
authors.lastname: Asboe
authors.forename: S
authors.initials: S
authors.lastname: Mandalia
authors.forename: M
authors.initials: M
authors.lastname: Boffito
authors.forename: N
authors.initials: N
authors.lastname: Davies
authors.forename: B
authors.initials: B
authors.lastname: Gazzard
authors.forename: J
authors.initials: J
authors.lastname: Catalan
mesh_terms: D015526:AIDS Dementia Complex / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology; D000203:Activities of Daily Living; D015897:Comorbidity; D004185:Disability Evaluation; D005260:Female; D006679:HIV Seropositivity / Q000150:complications* / Q000453:epidemiology / Q000523:psychology; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods; D009483:Neuropsychological Tests; D015995:Prevalence; D015397:Program Evaluation; D011788:Quality of Life; D012959:Socioeconomic Factors