Vascular cognitive impairment and HIV-associated neurocognitive disorder: a new paradigm

Cysique, Lucette A.; Brew, Bruce J.

doi:10.1007/s13365-018-0706-5

Cited by 67 publications

(61 citation statements)

References 115 publications

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“…A causative role of cerebral hypoperfusion and decreased perfusion of the inner retinal layers has been advanced to explain the association of CSVD with pRNFL and GCL thinning, as shown for CADASIL [50]. Our results agree with an emerging change of the NeuroHIV paradigm, highlighting the potential contribution of vascular brain damage in aging PLHIVs [16]. Despite being the first combined OCT-MRI study in middle-aged, cART-treated PLHIVs with well-sustained immune restoration, our study might suffer from a lack statistical power.…”

Section: Plos Onesupporting

confidence: 87%

“…To better characterize and differentiate CSVDsurrogate WMHs from WMHs of other origins, the STandards for ReportIng Vascular changes on Euroimaging (STRIVE) criteria, developed to standardize reading of CSVD neuroimages, were applied [9]. The results of several studies [12][13][14][15] documented the cognitive impact of CSVD-surrogate WMHs on cART-treated PLHIVs with long-term virus suppression, leading to the recent paradigm of vascular-driven, milder HAND forms [16].…”

Section: Introductionmentioning

confidence: 99%

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Absence of peripapillary retinal nerve-fiber–layer thinning in combined antiretroviral therapy-treated, well-sustained aviremic persons living with HIV

et al. 2020

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To compare peripapillary retinal nerve-fiber-layer (pRNFL) thickness, total retina macular volume, and ganglion-cell-layer (GCL) macular volume and thickness between persons living with HIV (PLHIVs) with well-controlled infections and good immune recovery, and sexand age-matched HIV-uninfected controls (HUCs). Methods This prospective cross-sectional study (www.clinicaltrials.gov identifier: NCT02003989) included 56 PLHIVs, infected for �10 [median 20.2] years and with sustained plasma HIVload suppression on combined antiretroviral therapy (cART) for �5 years, and 56 matched HUCs. Participants underwent spectral-domain optical coherence tomography (SD-OCT) with thorough ophthalmological examinations and brain magnetic resonance imaging (MRI). Their overall and quadrant pRNFL thicknesses, total macular volumes, and GCL macular volumes and thicknesses were compared. Cerebral small-vessel diseases (CSVD) complied with STRIVE criteria. Results Median [interquartile range, IQR] ages of PLHIVs and HUCs, respectively, were 52 [46-60] and 52 [44-60] years. Median [IQR] PLHIVs' nadir CD4+ T-cell count and current CD4/CD8 T-cell ratio were 249/μL [158-350] and 0.

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Section: Plos Onesupporting

confidence: 87%

Section: Introductionmentioning

confidence: 99%

Absence of peripapillary retinal nerve-fiber–layer thinning in combined antiretroviral therapy-treated, well-sustained aviremic persons living with HIV

et al. 2020

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“…In older PLWH neurodegenerative comorbidities are increasingly recognised but difficult to separate diagnostically [51] and particularly in milder HAND. Overlap with other conditions such as vascular cognitive impairment (VCI) is increasingly recognised [52]. These changing clinical phenotypes [26] may indicate that existing diagnostic criteria no longer accurately reflect HAND presentation [53].…”

Section: Current Cart Regimenmentioning

confidence: 99%

Screening for HIV-Associated Neurocognitive Disorder (HAND) in Adults Aged 50 and Over Attending a Government HIV Clinic in Kilimanjaro, Tanzania. Comparison of the International HIV Dementia Scale (IHDS) and IDEA Six Item Dementia Screen

et al. 2020

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Validated screening tools for HIV-associated neurocognitive disorders (HAND) are lacking for the newly emergent ageing population of people living with HIV (PLWH) in sub-Saharan Africa (SSA). We aimed to validate and compare diagnostic accuracy of two cognitive screening tools, the International HIV dementia scale (IHDS), and the Identification and Interventions for Dementia in Elderly Africans (IDEA) screen, for identification of HAND in older PLWH in Tanzania. A systematic sample of 253 PLWH aged ≥ 50 attending a Government clinic in Tanzania were screened with the IHDS and IDEA. HAND were diagnosed by consensus American Academy of Neurology (AAN) criteria based on detailed clinical neuropsychological assessment. Strict blinding was maintained between screening and clinical evaluation. Both tools had limited diagnostic accuracy for HAND (area under the receiver operating characteristic (AUROC) curve 0.639-0.667 IHDS, 0.647-0.713 IDEA), which was highly-prevalent (47.0%). Accurate HAND screening tools for older PLWH in SSA are needed. Keywords HIV • Older adults • Sub-Saharan Africa • Cognitive impairment • Screening • IHDS Resumen Faltan pruebas cognitivas válidas para los trastornos neurocognitivos asociados al VIH (según sus siglas en inglés, HIV-Associated Neurocognitive Disorder (HAND) en la población emergente de personas mayores que viven con el VIH en el África subsahariana. Nuestro objetivo era validar y comparar la precisión diagnóstica de dos pruebas cognitivas, la escala internacional de demencia por VIH (según sus siglas en ingles International HIV dementia scale (IHDS) y la prueba 'IDEA',

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“…Da HIV-Patienten nicht selten ein Lebensalter oberhalb der 70 Jahre erreichen, ist die wichtigste MRT-Differenzialdiagnose die subkortikale arteriosklerotische Enzephalopathie (SAE). Nur sehr erfahrene Befunder können hier differenzieren [12].…”

Section: Bildgebende Verfahrenunclassified

HIV-assoziierte neurokognitive Störungen

Arendt¹

2020

Nervenheilkunde

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ZUSAMMENFASSUNGDie HIV-Infektion ist infolge der raschen Entwicklung der antiretroviralen Therapie, als „cART“ = combination antiretroviral treatment bezeichnet, von einer tödlichen Seuche zu einer behandelbaren, chronischen Erkrankung geworden. Dennoch bleiben problematische Aspekte; vor allem die neurologischen Systemmanifestationen (HAND = HIV-associated neurological disorders) stellen weiterhin ein ungelöstes Problem dar. Auch wenn die HIV-assoziierte Demenz in ihrer klassischen Form mit motorischen, kognitiven und emotionalen Defiziten und rascher Progredienz selten geworden ist, bleiben milde Defizite, die gleichwohl die Betroffenen in ihrem Alltag und ihrer Lebensqualität einschränken. Somit ist ein wesentlicher Teil der Betreuung HIV-Positiver, diese Defizite möglichst zu verhindern (früher Therapiebeginn) bzw. früh zu erkennen und zu mildern. Es existiert eine diagnostische Nomenklatur, die Symptomzuordnungen vorgibt, anzuwendende diagnostische Methoden sind festgelegt, die wesentlichen Differenzialdiagnosen beschrieben. An diesen Vorgaben kann sich der in der Behandlung HIV-positiver Patienten unerfahrene Neurologe oder Psychiater orientieren.

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Vascular cognitive impairment and HIV-associated neurocognitive disorder: a new paradigm

Cited by 67 publications

References 115 publications

Absence of peripapillary retinal nerve-fiber–layer thinning in combined antiretroviral therapy-treated, well-sustained aviremic persons living with HIV

Absence of peripapillary retinal nerve-fiber–layer thinning in combined antiretroviral therapy-treated, well-sustained aviremic persons living with HIV

Screening for HIV-Associated Neurocognitive Disorder (HAND) in Adults Aged 50 and Over Attending a Government HIV Clinic in Kilimanjaro, Tanzania. Comparison of the International HIV Dementia Scale (IHDS) and IDEA Six Item Dementia Screen

HIV-assoziierte neurokognitive Störungen

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