Subscribe to RSS
DOI: 10.1055/s-2006-956759
Dementia and Neurocognitive Disorders Due to HIV-1 Infection
Publication History
Publication Date:
17 January 2007 (online)
![](https://www.thieme-connect.de/media/sin/200701/lookinside/thumbnails/10.1055-s-2006-956759-1.jpg)
ABSTRACT
Human immunodeficiency virus-type 1 (HIV-l) infection is the most common preventable and treatable cause of neurocognitive impairment in individuals under age 50 years. Although the incidence of HIV-associated dementia has decreased over the past few years due to combination antiretroviral therapy (cART), the prevalence of less severe HIV-associated neurocognitive impairment continues to increase. HIV-associated neurocognitive impairment is a significant burden to persons living with HIV infection, caregivers, and the health care system. Neurocognitive changes associated with HIV are typically subcortical, consisting of the triad of cognitive, behavior, and motor dysfunction. HIV-associated dementia and HIV-associated neurocognitive impairment are clinical diagnostic syndromes with neuropsychological performance testing, neuroimaging, and cerebral spinal fluid studies providing additional information. With the advent of more effective cART, the incidence of fatal opportunistic complications has dramatically diminished. Accordingly, the present review focuses on primary HIV-induced disease of the central nervous system, rather than its opportunistic complications.
KEYWORDS
HIV-associated dementia - AIDS - HIV neurocognitive impairment
REFERENCES
- 1 Reinvang I, Froland S S, Skripeland V. Prevalence of neuropsychological deficit in HIV infection: incipient signs of AIDS dementia complex in patients with AIDS. Acta Neurol Scand. 1991; 83 289-293
- 2 Sidtis J J, Gatsonis C, Price R W et al.. Zidovudine treatment of the AIDS dementia complex: results of a placebo-controlled trial. AIDS Clinical Trials Group. Ann Neurol. 1993; 33 343-349
- 3 Tozzi V, Balestra P, Serraino D et al.. Neurocognitive impairment and survival in a cohort of HIV-infected patients treated with HAART. AIDS Res Hum Retroviruses. 2005; 21 706-713
- 4 Masliah E, Heaton R K, Marcotte T D et al.. Dendritic injury is a pathological substrate for human immunodeficiency virus-related cognitive disorders. The HIV Neurobehavioral Research Center Group. Ann Neurol. 1997; 42 963-972
- 5 Gonzalez-Scarano F, Martin-Garcia J. The neuropathogenesis of AIDS. Nat Rev Immunol. 2005; 5 69-81
- 6 Price R W. The two faces of HIV infection of cerebrospinal fluid. Trends Microbiol. 2000; 8 387-391
- 7 McArthur J C, Brew B J, Nath A. Neurological complications of HIV infection. Lancet Neurol. 2005; 4 543-555
- 8 Wiley C A, Achim C L, Christopherson C et al.. HIV mediates a productive infection of the brain. AIDS. 1999; 13 2055-2059
- 9 Carey C L, Woods S P, Rippeth J D et al.. Initial validation of a screening battery for the detection of HIV-associated cognitive impairment. Clin Neuropsychol. 2004; 18 234-248
- 10 Ellis R J, Evans S R, Clifford D B et al.. Clinical validation of the NeuroScreen. J Neurovirol. 2005; 11 503-511
- 11 Chang L, Tomasi D, Yakupov R et al.. Adaptation of the attention network in human immunodeficiency virus brain injury. Ann Neurol. 2004; 56 259-272
- 12 Ances B M, Roc A C, Wang J et al.. Caudate blood flow and volume are reduced in HIV + neurocognitively impaired patients. Neurology. 2006; 66 862-866
- 13 Cysique L A, Brew B J, Halman M et al.. Undetectable cerebrospinal fluid HIV RNA and beta-2 microglobulin do not indicate inactive AIDS dementia complex in highly active antiretroviral therapy-treated patients. J Acquir Immune Defic Syndr. 2005; 39 426-429
- 14 Ellis R J, Hsia K, Spector S A et al.. Cerebrospinal fluid human immunodeficiency virus type 1 RNA levels are elevated in neurocognitively impaired individuals with acquired immunodeficiency syndrome. The HIV Neurobehavioral Research Center Group. Ann Neurol. 1997; 42 679-688
- 15 Hinkin C H, Hardy D J, Mason K I et al.. Medication adherence in HIV-infected adults: effect of patient age, cognitive status, and substance abuse. AIDS. 2004; 18(suppl 1) S19-S25
- 16 Yazdanian M. Blood-brain barrier properties of human immunodeficiency virus antiretrovirals. J Pharm Sci. 1999; 80 950-954
- 17 Letendre S L, McCutchan J A, Childers M E et al.. Enhancing antiretroviral therapy for human immunodeficiency virus cognitive disorders. Ann Neurol. 2004; 56 416-423
-
18 McCutchan J A, Letendre S L.
Pharmacology of antiretorviral drugs in the central nervous system: pharmacokinetics, antiretoviral resistance, and pharmacodynamics . In: Gendelman HE, Grant I, Everall IP, et al. The Neurology of AIDS. 2nd ed. New York; Oxford University Press 2005: 729-734
Ronald J EllisM.D. Ph.D.
HIV Neurobehavioral Research Center
150 W. Washington, 2nd Floor, San Diego, CA 92103