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Assessment, diagnosis, and treatment of HIV-associated neurocognitive disorder:A consensus report of the mind exchange program

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The Mind Exchange Working Group, Antinori, A., Arendt, G., Grant, I., Letendre, S., Chair, Munoz-Moreno, J. A., Eggers, C. +59 more·2013·Clinical Infectious Diseases

Abstract

Many practical clinical questions regarding the management of human immunodeficiency virus (HIV)-associated neurocognitive disorder (HAND) remain unanswered. We sought to identify and develop practical answers to key clinical questions in HAND management. Sixty-six specialists from 30 countries provided input into the program, which was overseen by a steering committee. Fourteen questions were rated as being of greatest clinical importance. Answers were drafted by an expert group based on a comprehensive literature review. Sixty-three experts convened to determine consensus and level of evidence for the answers. Consensus was reached on all answers. For instance, good practice suggests that all HIV patients should be screened for HAND early in disease using standardized tools. Follow-up frequency depends on whether HAND is already present or whether clinical data suggest risk for developing HAND. Worsening neurocognitive impairment may trigger consideration of antiretroviral modification when other causes have been excluded. The Mind Exchange program provides practical guidance in the diagnosis, monitoring, and treatment of HAND.

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  • Risk factors commonly associated with HAD include female sex, being elderly, higher HIV viral titers, lower socioeconomic group, substance abuse, and iron-deficiency anemia.

    “Risk factors commonly associated with HAD are female sex, being elderly, higher HIV viral titers, lower socioeconomic group, substance abuse, and iron-deficiency anemia.[7]”

    From Management of psychiatric disorders with HIV and dermatological disorders (2022) · cites this paper as [7]

    The Results risk-factor table lists high HIV RNA, older age, poverty, illicit drug or alcohol abuse, anemia, and female sex in some countries where it is associated with lower socioeconomic status. But the table addresses HAND and/or non-HIV-related neurocognitive impairment, not HAD specifically; it also does not identify the anemia as iron-deficiency anemia or present female sex as an unqualified risk factor. (LLM, conf=0.88)

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Authors
The Mind Exchange Working Group, Antinori, A., Arendt, G., Grant, I., Letendre, S., Chair, Munoz-Moreno, J. A., Eggers, C., Brew, B., Brouillette, M.-J., Bernal-Cano, F., Carvalhal, A., Christo, P. P., Cinque, P., Cysique, L., Ellis, R., Everall, I., Gasnault, J., Husstedt, I., Korten, V., Machala, L., Obermann, M., Ouakinin, S., Podzamczer, D., Portegies, P., Rackstraw, S., Rourke, S., Sherr, L., Streinu-Cercel, A., Winston, A., Wojna, V., Yazdanpannah, Y., Arbess, G., Baril, J.-G., Begovac, J., Bergin, C., Bonfanti, P., Bonora, S., Brinkman, K., Canestri, A., Cholewinska-Szymanska, G., Chowers, M., Cooney, J., Corti, M., Doherty, C., Elbirt, D., Esser, S., Florence, E., Force, G., Gill, J., Goffard, J.-C., Harrer, T., Li, P., de Kerckhove, L. V., Knecht, G., Matsushita, S., Matulionyte, R., McConkey, S., Mouglignier, A., Oka, S., Penalva, A., Riesenberg, K., Sambatakou, H., Tozzi, V., Vassallo, M., Wetterberg, P., & Drapato, A. W.
Affiliations
  • Heinrich Heine University Düsseldorf (DE)
  • University of California San Diego (US)
  • Universitat Autònoma de Barcelona (ES)
Corresponding author
  • Cinque, P.
  • Cysique, L.
  • Korten, V.
  • Obermann, M.
  • Ouakinin, S.
  • Portegies, P.
  • Rackstraw, S.
  • Rourke, S.
  • Bonfanti, P.
  • Corti, M.
  • Doherty, C.
  • Elbirt, D.
  • Esser, S.
  • Goffard, J.-C.
  • Knecht, G.
  • Matsushita, S.
  • Mouglignier, A.
Venue
Clinical Infectious Diseases
Published
2012-11-21
Volume
56
Issue
7
Pages
1004-1017
ISSN
  • 1058-4838 (ISSN-L)
  • 1537-6591
OpenAlex
W2056277253
Cited by
208
References
111
Citations by year
2026: 3 · 2025: 6 · 2024: 9 · 2023: 14 · 2022: 14 · 2021: 16 · 2020: 19 · 2019: 21 · 2018: 16 · 2017: 18 · 2016: 15 · 2015: 18 · 2014: 25 · 2013: 14
FWCI
8.15
Type
journal article
Language
en
Open access
Locations
  • Clinical Infectious Diseases (publishedVersion)
  • Europe PMC (PubMed Central) (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • Data Archiving and Networked Services (DANS) (submittedVersion)
  • BOA (University of Milano-Bicocca) (submittedVersion)
  • Institutional Research Information System University of Turin (University of Turin) (submittedVersion)
  • Pure Amsterdam UMC (submittedVersion)
  • Repositorio Institucional (Pontificia Universidad Javeriana) (submittedVersion, cc-by-nc)
Funders
National Institute of Neurological Disorders and Stroke (S11NS046278, U54NS043011)
Topics
  • Life Sciences › Immunology and Microbiology › Virology › HIV Research and Treatment
  • Health Sciences › Medicine › Surgery › Infectious Diseases and Tuberculosis
  • Health Sciences › Medicine › Infectious Diseases › HIV/AIDS drug development and treatment
Keywords
HIV-associated neurocognitive disorders, HIV
MeSH terms
Humans, AIDS Dementia Complex, HIV Infections, Drug Monitoring, Practice Guidelines as Topic, Antiretroviral Therapy, Highly Active, Anti-Retroviral Agents

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