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 language | English (US) |
|---|---|
| Pages (from-to) | 1139-1151 |
| Number of pages | 13 |
| Journal | The Lancet Neurology |
| Volume | 13 |
| Issue number | 11 |
| DOIs | |
| State | Published - Nov 1 2014 |
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ASJC Scopus subject areas
- Clinical Neurology
Cite this
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 journal › Article
}
TY - JOUR
T1 - Controversies in HIV-associated neurocognitive disorders
AU - Nightingale, Sam
AU - Winston, Alan
AU - Letendre, Scott
AU - Michael, Benedict D.
AU - McArthur, Justin Charles
AU - Khoo, Saye
AU - Solomon, Tom
PY - 2014/11/1
Y1 - 2014/11/1
N2 - 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.
AB - 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.
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U2 - 10.1016/S1474-4422(14)70137-1
DO - 10.1016/S1474-4422(14)70137-1
M3 - Article
VL - 13
SP - 1139
EP - 1151
JO - The Lancet Neurology
JF - The Lancet Neurology
SN - 1474-4422
IS - 11
ER -