After 10 years since the introduction of highly active antiretroviral therapy (HAART), the criteria for classifying HIV-related neurocognitive disorders may need to be revised and updated, according to a working group designated by NIMH and the National Institute of Neurological Disorders and Stroke to study the issue. The study was published October 30, 2007, in the journal Neurology.
The current criteria, first established in 1991, describe two categories of neurological disorders associated with HIV infection—HIV-associated dementia and the less severe minor cognitive motor disorder. However, in the decade since HAART became widely available, the treatment has been shown to modify the progression of HIV-associated neurological disorders, leading the working group to conclude that the existing categories no longer encompass all forms of HIV-associated neurological conditions. Therefore, it suggested that a third type of HIV-associated neurological disorder be adopted—asymptomatic neurocognitive impairment (ANI). ANI would apply to those HIV patients who exhibit slight neurocognitive impairment, but do not show overt signs of it.
The researchers acknowledge that coexisting disorders and other complex factors may complicate the suggested new categorization, but they provided a formula designed to tease out how these coexisting disorders may affect the HIV-related neurocognitive disorder. They conclude that further research is needed to support the recommended changes.
Reference
Antinori A, et al. Updated research nosology for HIV-associated neurocognitive disorders . Neurology. 2007 Oct 30;69(18):1789-99.
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