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Researchers Suggest Updating Criteria for HIV-associated Neurocognitive Disorders

Science Update

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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HIV/AIDS-related research is funded and conducted in accordance with the NIH Office of AIDS Research (OAR), which was created by Congress in 1988 and strengthened in the NIH Revitalization Act of 1993. OAR is responsible for planning, coordinating, evaluating and determining the budget for AIDS research across the many institutes and centers within NIH, including NIMH.

Within NIMH, the Division of AIDS and Health and Behavior Research supports research that includes understanding and treating the molecular and cellular basis of HIV/AIDS central nervous system disease; developing and disseminating effective interventions to prevent the further spread of HIV; and developing strategies to understand, prevent, and delay adverse health outcomes among individuals already infected with HIV.