title: Interventions for Neurocognitive Dysfunction.
abstract: This study aimed to evaluate current barriers to HIV cure strategies and interventions for neurocognitive dysfunction with a particular focus on recent advancements over the last 3 years.
  
  
  
  Optimal anti-retroviral therapy (ART) poses challenges to minimise neurotoxicity, whilst ensuring blood-brain barrier penetration and minimising the risk of cerebrovascular disease. CSF biomarkers, BCL11B and neurofilament light chain may be implicated with a neuroinflammatory cascade leading to cognitive impairment. Diagnostic imaging with diffusion tensor imaging and resting-state fMRI show promise in future diagnosis and monitoring of HAND. The introduction of ART has resulted in a dramatic decline in HIV-associated dementia. Despite this reduction, milder forms of HIV-associated neurocognitive disorder (HAND) are still prevalent and are clinically significant. The central nervous system (CNS) has been recognised as a probable reservoir and sanctuary for HIV, representing a significant barrier to management interventions.
authors.affiliation: Department of Neurology, St Vincent's Hospital, Sydney, 390 Victoria St, Darlinghurst, NSW, 2010, Australia.
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Ellero
authors.affiliation: Department of Neurology, St Vincent's Hospital, Sydney, 390 Victoria St, Darlinghurst, NSW, 2010, Australia.|School of Medicine, Sydney, The University of Notre Dame Australia, Sydney, 160 Oxford St, Darlinghurst, NSW, 2010, Australia.
authors.forename: Michal
authors.initials: M
authors.lastname: Lubomski
authors.affiliation: School of Medicine, Sydney, The University of Notre Dame Australia, Sydney, 160 Oxford St, Darlinghurst, NSW, 2010, Australia. B.Brew@UNSW.edu.au.|Departments of Neurology and Immunology, St Vincent's Hospital, Sydney, Level 4 Xavier Building. 390 Victoria St, Darlinghurst, NSW, 2010, Australia. B.Brew@UNSW.edu.au.|Peter Duncan Neurosciences Unit, St Vincent's Centre for Applied Medical Research, Sydney, Darlinghurst, NSW, 2010, Australia. B.Brew@UNSW.edu.au.|School of Medicine, University of New South Wales, Sydney, NSW, 2052, Australia. B.Brew@UNSW.edu.au.
authors.forename: Bruce
authors.initials: B
authors.lastname: Brew
mesh_terms: D019380:Anti-HIV Agents / Q000009:adverse effects / Q000627:therapeutic use; D015415:Biomarkers; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D019965:Neurocognitive Disorders / Q000209:etiology* / Q000628:therapy*
chemical_list: D019380:Anti-HIV Agents; D015415:Biomarkers
keywords: CNS reservoir; Cerebrovascular disease; Dementia; HIV; Hand; Neurocognitive dysfunction; Neuroimaging; Neurotoxicity