title: Can antiretroviral therapy prevent HIV-associated cognitive disorders?
abstract: OBJECTIVE
  In general, the initiation of combination antiretroviral (cART) is associated with improvement in cognitive function. However, the impact of cART has on cognitive function in neurologically asymptomatic HIV-infected individuals initiating therapy at high CD4 lymphocyte cell counts is unknown.
  
  
  RESULTS
  Cognitive function impairment remains prevalent despite effective cART. Several clinical risk factors for this condition have been described, including low nadir CD4 lymphocyte cell count which may be associated with greater neuroinflammatory process, a potential pathogenic mechanism underlying this cognitive impairment. The earlier initiation of antiretroviral therapy could theoretically avoid this risk factor and limit the degree of neuroinflammation. On the converse, the earlier initiation of cART may be associated with the development of neuronal toxicities.
  
  
  CONCLUSIONS
  This review article highlights the recent literature and arguments for and against the earlier initiation of cART with regards to cognitive function.
authors.affiliation: aFaculty of Medicine, Department of Medicine, Imperial College London, St Mary's Hospital Campus bDepartment of HIV and Genitourinary Medicine, Imperial College Healthcare NHS Trust, London, UK.
authors.forename: Alan
authors.initials: A
authors.lastname: Winston
authors.forename: Jaime H
authors.initials: JH
authors.lastname: Vera
mesh_terms: D044966:Anti-Retroviral Agents / Q000009:adverse effects / Q000627:therapeutic use; D018791:CD4 Lymphocyte Count; D003072:Cognition Disorders / Q000209:etiology / Q000517:prevention & control; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy; D006801:Humans
chemical_list: D044966:Anti-Retroviral Agents