Neurologic complications and considerations in HIV-infected persons

Neurologic complications for HIV-infected persons retain significant prevalence despite an increasingly global use of antiretroviral therapies. Such complications are often ascribed to advanced immunosuppression; however, the most common neurologic problems for HIV-infected persons, distal sensory polyneuropathy and HIV-associated neurocognitive disorders, affect a significant proportion of patients who have successfully achieved immunologic restoration with normal or near-normal CD4 count levels and undetectable HIV RNA in the periphery. Understanding specific considerations for HIV-associated complications, including the epidemiology, risk factors, medication-adverse effects, and benefits of appropriate management, is vital for all providers caring for those with HIV. This review will describe such considerations, as well as providing a more detailed review of the most common neurologic complications of HIV infection, and will highlight some of the challenges involved with diagnosis, management, and long-term effects.