title: HIV and neurocognitive dysfunction.
abstract: The spectrum of HIV-associated neurocognitive disorder (HAND) has been dramatically altered in the setting of widely available effective antiretroviral therapy (ART). Once culminating in dementia in many individuals infected with HIV, HAND now typically manifests as more subtle, though still morbid, forms of cognitive impairment in persons surviving long-term with treated HIV infection. Despite the substantial improvement in severity of this disorder, the fact that neurologic injury persists despite ART remains a challenge to the community of patients, providers and investigators aiming to optimize quality of life for those living with HIV. Cognitive dysfunction in treated HIV may reflect early irreversible CNS injury accrued before ART is typically initiated, ongoing low-level CNS infection and progressive injury in the setting of ART, or comborbidities including effects of treatment which may confound the beneficial reduction in viral replication and immune activation effected by ART.
authors.affiliation: Department of Neurology, Yale University, 300 George Street, Room 8300c, New Haven, CT 06510, USA. serena.spudich@yale.edu
authors.forename: Serena
authors.initials: S
authors.lastname: Spudich
mesh_terms: D019380:Anti-HIV Agents / Q000627:therapeutic use; D002490:Central Nervous System / Q000821:virology; D003072:Cognition Disorders / Q000209:etiology*; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy; D006801:Humans
chemical_list: D019380:Anti-HIV Agents