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Interventions for Neurocognitive Dysfunction

  • HIV Pathogenesis and Treatment (AL Landay and N Utay, Section Editors)
  • Published:
Current HIV/AIDS Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

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.

Recent Findings

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.

Summary

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.

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Authors and Affiliations

  1. Department of Neurology, St Vincent’s Hospital, Sydney, 390 Victoria St, Darlinghurst, NSW, 2010, Australia

    Jacqueline Ellero & Michal Lubomski

  2. School of Medicine, Sydney, The University of Notre Dame Australia, Sydney, 160 Oxford St, Darlinghurst, NSW, 2010, Australia

    Michal Lubomski & Bruce Brew

  3. Departments of Neurology and Immunology, St Vincent’s Hospital, Sydney, Level 4 Xavier Building. 390 Victoria St, Darlinghurst, NSW, 2010, Australia

    Bruce Brew

  4. Peter Duncan Neurosciences Unit, St Vincent’s Centre for Applied Medical Research, Sydney, Darlinghurst, NSW, 2010, Australia

    Bruce Brew

  5. School of Medicine, University of New South Wales, Sydney, NSW, 2052, Australia

    Bruce Brew

Authors
  1. Jacqueline Ellero
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  2. Michal Lubomski
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  3. Bruce Brew
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Corresponding author

Correspondence to Bruce Brew.

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Conflict of Interest

Jacqueline Ellero, Michal Lubomski, and Bruce Brew declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on HIV Pathogenesis and Treatment

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Ellero, J., Lubomski, M. & Brew, B. Interventions for Neurocognitive Dysfunction. Curr HIV/AIDS Rep 14, 8–16 (2017). https://doi.org/10.1007/s11904-017-0346-z

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