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01-08-2016 | Complications of Antiretroviral Therapy (G McComsey, Section Editor)

Cognitive Impairment and Persistent CNS Injury in Treated HIV

Authors: Phillip Chan, Joanna Hellmuth, Serena Spudich, Victor Valcour

Published in: Current HIV/AIDS Reports | Issue 4/2016

Abstract

The implementation of combination antiretroviral therapy (cART) has changed HIV infection into a chronic illness, conveying extensive benefits, including greater longevity and advantages for the central nervous system (CNS). However, studies increasingly confirm that the CNS gains are incomplete, with reports of persistent immune activation affecting the CNS despite suppression of plasma HIV RNA. The rate of cognitive impairment is unchanged, although severity is generally milder than in the pre-cART era. In this review, we discuss cognitive outcomes from recently published clinical HIV studies, review observations on HIV biomarkers for cognitive change, and emphasize longitudinal imaging findings. Additionally, we summarize recent studies on CNS viral invasion, CD8 encephalitis, and how CNS involvement during the earliest stages of infection may set the stage for later cognitive manifestations.

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Title: Cognitive Impairment and Persistent CNS Injury in Treated HIV
Authors: Phillip Chan
Joanna Hellmuth
Serena Spudich
Victor Valcour
Publication date: 01-08-2016
Publisher: Springer US
Published in: Current HIV/AIDS Reports / Issue 4/2016
Print ISSN: 1548-3568
Electronic ISSN: 1548-3576
DOI: https://doi.org/10.1007/s11904-016-0319-7

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