Updated research nosology for HIV-associated neurocognitive disorders.

Neurology, 2007; 69 (18) doi:10.1212/01.WNL.0000287431.88658.8b

Authors: Antinori A, Arendt G, Becker J T, Brew B J, Byrd D A et al.(19)

Affiliation: National Institute for Infectious Diseases Lazzaro Spallanzani, Rome, Latium, Italy

Abstract: In 1991, the AIDS Task Force of the American Academy of Neurology published nomenclature and research case definitions to guide the diagnosis of neurologic manifestations of HIV-1 infection. Now, 16 years later, the National Institute of Mental Health and the National Institute of Neurological Diseases and Stroke have charged a working group to critically review the adequacy and utility of these definitional criteria and to identify aspects that require updating. This report represents a majority view, and unanimity was not reached on all points. It reviews our collective experience with HIV-associated neurocognitive disorders (HAND), particularly since the advent of highly active antiretroviral treatment, and their definitional criteria; discusses the impact of comorbidities; and suggests inclusion of the term asymptomatic neurocognitive impairment to categorize individuals with subclinical impairment. An algorithm is proposed to assist in standardized diagnostic classification of HAND.

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