HIV Associated Neurocognitive Disorders

HIV Associated Neurocognitive Disorders (HAND) can occur when HIV enters the nervous system and impacts the health of nerve cells. This, in turn, can impair the activity of nerves involved in:

• Attention
• Memory
• Language
• Problem solving
• Decision making.

Together, these activities are known as cognition.

What are the symptoms of HAND?

Symptoms of HAND can include:

• Confusion
• Forgetfulness
• Behavioral changes
• Headaches
• Gradual weakening and loss of feeling in the arms and legs
• Problems with cognition or movement
• Pain due to nerve damage.

How many disorders are considered HAND?

There are several different types of HAND:

• Asymptomatic Neurocognitive Impairment (ANI) is diagnosed if testing shows HIV-associated impairment in cognitive function, but everyday functioning is not affected.
• Mild Neurocognitive Disorder (MND) is diagnosed if testing shows HIV-associated impairment in cognitive function, and mild interference in everyday functioning.
• HIV-associated Dementia (HAD) is diagnosed if testing shows marked impairment in cognitive function, especially in learning of new information, information processing, and attention or concentration. This impairment significantly limits your ability to function day-to-day at work, home, and during social activities.

MND appears to be the most common type of HAND. Despite its name, even mild cognitive problems can interfere with everyday functioning and reduce quality of life.

How are HAND diagnosed and treated?

Experienced neurologists can diagnose HAND after carefully ruling out other possible causes of the symptoms. They may conduct a thorough neurological exam and history, brain MRI scan, and sometimes lumbar puncture to evaluate the cerebrospinal fluid. Neuropsychological testing can add useful information about the nature and severity of HAND.

Highly active anti-retroviral therapy (HAART) can effectively improve cognitive abilities. Talk to your doctor if you think you have symptoms of HAND.