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HIV-associated neurocognitive disorders: Management

Richard W Price, MD
Section Editor
John G Bartlett, MD
Deputy Editor
Allyson Bloom, MD


Changes in memory, concentration, attention, and motor skills are common in HIV-infected patients [1]. When not clearly attributable to an alternate cause other than HIV infection, such neurocognitive impairments have been collectively classified as HIV-associated neurocognitive disorders (HAND). The main therapeutic approach to HAND is antiretroviral therapy (ART).

The management of HIV-associated neurocognitive disorders will be discussed here. The epidemiology, clinical manifestations, and diagnosis of HIV-associated neurocognitive disorders are discussed elsewhere. (See "HIV-associated neurocognitive disorders: Epidemiology, clinical manifestations, and diagnosis".)

An overview of the range of neuropsychiatric conditions associated with HIV infection and more detailed reviews of other specific conditions are discussed separately. (See "Overview of the neuropsychiatric aspects of HIV infection and AIDS" and "Depression, mania, and schizophrenia in HIV-infected patients" and "Substance abuse and addiction in HIV-infected patients".)


The presence of neurocognitive deficits in certain HIV-infected individuals without alternative explanation other than HIV infection has long been described. However, the terminology to refer to this phenomenon has undergone substantial evolution since its initial characterization.

This topic uses a widely employed classification scheme that groups such neurocognitive deficits under the umbrella term, HIV-associated neurocognitive disorders (HAND). The range of deficits included in this scheme is defined by performance on standardized neuropsychological testing. In general terms, HIV-associated dementia refers to severe neurocognitive deficits that lead to substantial functional impairment. Milder deficits are termed mild neurocognitive disorder (MND) if they lead to minor symptoms or impairment and asymptomatic neurocognitive impairment (ANI) if they do not. This is discussed in detail elsewhere. (See "HIV-associated neurocognitive disorders: Epidemiology, clinical manifestations, and diagnosis", section on 'Terminology'.)

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Literature review current through: Nov 2017. | This topic last updated: Aug 21, 2015.
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