Survival rates for people living with HIV-AIDS has dramatically improved due to advances in the combination antiretroviral therapies (ART). However, in spite of these advances HIV associated neurocognitive disorders (HAND) creates concerns for medical care providers. Approximately 30 percent of persons with asymptomatic HIV infections and 50 percent of those with acquired immunodeficiency syndrome (AIDS) do exhibit signs and symptoms of some mild neurological disease. Not all neurocognitive problems associated with an HIV infection are progressive. Some of the problems may resolve themselves over time with an appropriate treatment programs.
HIV infections affect five areas of neurocognitive functioning: executive functioning, episodic memory, speed of processing information, motor/movement skills, attention and working memory, use of language, and sensori-perception. Diagnosing HAND can be difficult because there is a high prevalence of other diseases of the central nervous system. Sometimes a diagnosis is determined by the presence or absence of a person’s self-reported declines in normal everyday functioning as we all as other markers associated with the person’s medical history.
The most severe form of HAND is HIV associated dementia (HAD). The criteria for this condition are a moderate to a severe decline in cognitive functioning in at least two areas: language, attention, comprehension, reasoning, memory or motor skills. A person will also experience diminished daily activities. Fortunately, a combination of antiretroviral therapies (ART) has led to the decline of this condition. Researchers now estimate that 1to 2% of HIV positive persons meet the criteria for HAD.
Due to advances in the treatment of HIV there are a growing number of long-term survivors. These survivors are adding to the aging population which comes with the problem of HIV associated Alzheimer’s disease. Aging long-term HIV survivors will also have a greater vulnerability to common non-HIV pathogens that may contribute to the development of Alzheimer’s. This is an area that researchers will no doubt keep an eye on due to the unknown long-term medical complications.