Controversies in HIV-associated neurocognitive disorders

Sam Nightingale, Alan Winston, Scott Letendre, Benedict D. Michael, Justin Charles McArthur, Saye Khoo, Tom Solomon

Research output: Contribution to journalArticle

Abstract

Cross-sectional studies show that around half of individuals infected with HIV-1 have some degree of cognitive impairment despite the use of antiretroviral drugs. However, prevalence estimates vary depending on the population and methods used to assess cognitive impairment. Whether asymptomatic patients would benefit from routine screening for cognitive difficulties is unclear and the appropriate screening method and subsequent management is the subject of debate. In some patients, HIV-1 RNA can be found at higher concentrations in CSF than in blood, which potentially results from the poor distribution of antiretroviral drugs into the CNS. However, the clinical relevance of so-called CSF viral escape is not well understood. The extent to which antiretroviral drug distribution and toxicity in the CNS affect clinical decision making is also debated.

Original languageEnglish (US)
Pages (from-to)1139-1151
Number of pages13
JournalThe Lancet Neurology
Volume13
Issue number11
DOIs
StatePublished - Nov 1 2014

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HIV-1
HIV
Drug-Related Side Effects and Adverse Reactions
Pharmaceutical Preparations
Cross-Sectional Studies
RNA
Population
Cognitive Dysfunction
Neurocognitive Disorders
Clinical Decision-Making

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

Nightingale, S., Winston, A., Letendre, S., Michael, B. D., McArthur, J. C., Khoo, S., & Solomon, T. (2014). Controversies in HIV-associated neurocognitive disorders. The Lancet Neurology, 13(11), 1139-1151. https://doi.org/10.1016/S1474-4422(14)70137-1

Controversies in HIV-associated neurocognitive disorders. / Nightingale, Sam; Winston, Alan; Letendre, Scott; Michael, Benedict D.; McArthur, Justin Charles; Khoo, Saye; Solomon, Tom.

In: The Lancet Neurology, Vol. 13, No. 11, 01.11.2014, p. 1139-1151.

Research output: Contribution to journalArticle

Nightingale, S, Winston, A, Letendre, S, Michael, BD, McArthur, JC, Khoo, S & Solomon, T 2014, 'Controversies in HIV-associated neurocognitive disorders', The Lancet Neurology, vol. 13, no. 11, pp. 1139-1151. https://doi.org/10.1016/S1474-4422(14)70137-1
Nightingale S, Winston A, Letendre S, Michael BD, McArthur JC, Khoo S et al. Controversies in HIV-associated neurocognitive disorders. The Lancet Neurology. 2014 Nov 1;13(11):1139-1151. https://doi.org/10.1016/S1474-4422(14)70137-1
Nightingale, Sam ; Winston, Alan ; Letendre, Scott ; Michael, Benedict D. ; McArthur, Justin Charles ; Khoo, Saye ; Solomon, Tom. / Controversies in HIV-associated neurocognitive disorders. In: The Lancet Neurology. 2014 ; Vol. 13, No. 11. pp. 1139-1151.
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