- Target Audience
- Overall Learning Objectives
- Faculty
- Physician Continuing Medical Education
- Pharmacist Continuing Education
- Nursing Continuing Education
- Disclosure of Conflicts of Interest
- Disclosure of Unlabeled Use
- 1. Epidemiology and the Spread of HIV
- 2. The Origin, Evolution, and Epidemiology of HIV-1 and HIV-2
- 3. Mechanisms of HIV Transmission
- 4. HIV Transmission Prevention
- 5. Immunology
- 6. HIV Cure Strategies<sup>a</sup>
- 7. HIV Testing and Counseling
- 8. Laboratory Testing Strategies
- 9. The Medical History and Physical Examination of the HIV-Infected Patient
- 10. Initial Laboratory Evaluation and Risk Stratification of the HIV-Infected Patient
- 11. Clinical Syndromes and Differential Diagnosis in the HIV-Infected Patient
- 12. Health Maintenance
- 13. Issues in Specific Patient Populations
- 14. Complementary and Alternative Medicine/Integrative Medicine Approaches
- 15. Care Coordination
- 16. Palliative Care and End-of-Life Support
- 17. HIV Virology
- 18. Principles of Applied Clinical Pharmacokinetics and Pharmacodynamics in Antiretroviral Therapy
- 19. Classes of Antiretrovirals
- 20. Initiation of Antiretroviral Therapy
- 21. HIV-1 Resistance to Antiretroviral Drugs
- 22. Managing the Patient with Multidrug-Resistant HIV
- 23. Future Antiretrovirals, Immune-Based Strategies, and Therapeutic Vaccines
- 24. The Pharmacist’s Role in Caring for HIV-Positive Individuals
- 25. Solid Organ Transplantation in HIV-Infected Individuals
- 26. Antiretroviral Therapy in Pregnant Women
- 27. Antiretroviral Therapy in Children and Newborns
- 28. Immunosuppressants and Antiretroviral Therapy in HIV-Positive Transplant Patients
- 29. Understanding and Managing Antineoplastic and Antiretroviral Therapy
- 30. Substance Abuse in HIV Populations
- 31. Understanding the Use of Antiretroviral Drugs in the Aging Patient
- 32. Opportunistic Infections
- 33. Malignant Diseases in HIV
- 34. Dermatologic Complications
- 35. Endocrine Disorders
- 36. Non-opportunistic Infections
- 37. Psychiatric Illness and Treatment in HIV Populations
- 38. HIV-Associated Neurocognitive Disorders
- 39. HIV/Hepatitis Co-infection
- 40. Ocular Complications
- 41. Cardiovascular Disease
- 42. Renal Complications
- 43. Musculoskeletal Complications of HIV
- 44. Sexually Transmitted Diseases
- 45. HIV and Bone Health
- 46. HIV-Associated Lipodystrophy and Lipoatrophy
- 47. Dyslipidemia
- 48. Immune Reconstitution Inflammatory Syndrome
- 49. US Health Care Systems, HIV Programs, and Coverage Policy Issues
- 50. Legal Issues<sup>a</sup>
- 51. Research Design and Analysis
- 52. Ethical Conduct of Clinical Trials, Institutional Review Boards, Informed Consent, and Financial Conflicts of Interest
- Index
(p. 427) HIV-Associated Neurocognitive Disorders
- Chapter:
- (p. 427) HIV-Associated Neurocognitive Disorders
- Author(s):
Rodrigo Hasbun
, Richard Dunham
, Joseph S. Kass
, Rituparna Das
, Karen Nunez-Wallace
, Lydia J. Sharp
, and Doris Kung
- DOI:
- 10.1093/med/9780190493097.003.0038
HIV causes a chronic form of encephalitis (HIVE) that is clinically characterized by either dementia or mild neurocognitive impairment. Since the introduction of antiretroviral therapy in 1996, the incidence of HIV dementia has decreased by 50%, but the prevalence of mild neurocognitive disorder has increased up to 39%. HIVE is the result of direct microglial infection, interruption of trophic factors, or caused by inflammatory cytokines. HIV enters the brain primarily by the “Trojan horse mechanism”; it is carried by monocytes and lymphocytes that cross the blood–brain barrier. HIV has a predilection for the basal ganglia, deep white matter, and hippocampus, resulting in a subcortical dementia. HIV dementia is a diagnosis of exclusion and other co-infections, cerebrovascular disease, malnutrition, and drug abuse should be ruled out before making the diagnosis. In patients receiving antiretroviral therapy with immunological response, a novel condition termed CD8+ T cell encephalitis was recently described.
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- Target Audience
- Overall Learning Objectives
- Faculty
- Physician Continuing Medical Education
- Pharmacist Continuing Education
- Nursing Continuing Education
- Disclosure of Conflicts of Interest
- Disclosure of Unlabeled Use
- 1. Epidemiology and the Spread of HIV
- 2. The Origin, Evolution, and Epidemiology of HIV-1 and HIV-2
- 3. Mechanisms of HIV Transmission
- 4. HIV Transmission Prevention
- 5. Immunology
- 6. HIV Cure Strategies<sup>a</sup>
- 7. HIV Testing and Counseling
- 8. Laboratory Testing Strategies
- 9. The Medical History and Physical Examination of the HIV-Infected Patient
- 10. Initial Laboratory Evaluation and Risk Stratification of the HIV-Infected Patient
- 11. Clinical Syndromes and Differential Diagnosis in the HIV-Infected Patient
- 12. Health Maintenance
- 13. Issues in Specific Patient Populations
- 14. Complementary and Alternative Medicine/Integrative Medicine Approaches
- 15. Care Coordination
- 16. Palliative Care and End-of-Life Support
- 17. HIV Virology
- 18. Principles of Applied Clinical Pharmacokinetics and Pharmacodynamics in Antiretroviral Therapy
- 19. Classes of Antiretrovirals
- 20. Initiation of Antiretroviral Therapy
- 21. HIV-1 Resistance to Antiretroviral Drugs
- 22. Managing the Patient with Multidrug-Resistant HIV
- 23. Future Antiretrovirals, Immune-Based Strategies, and Therapeutic Vaccines
- 24. The Pharmacist’s Role in Caring for HIV-Positive Individuals
- 25. Solid Organ Transplantation in HIV-Infected Individuals
- 26. Antiretroviral Therapy in Pregnant Women
- 27. Antiretroviral Therapy in Children and Newborns
- 28. Immunosuppressants and Antiretroviral Therapy in HIV-Positive Transplant Patients
- 29. Understanding and Managing Antineoplastic and Antiretroviral Therapy
- 30. Substance Abuse in HIV Populations
- 31. Understanding the Use of Antiretroviral Drugs in the Aging Patient
- 32. Opportunistic Infections
- 33. Malignant Diseases in HIV
- 34. Dermatologic Complications
- 35. Endocrine Disorders
- 36. Non-opportunistic Infections
- 37. Psychiatric Illness and Treatment in HIV Populations
- 38. HIV-Associated Neurocognitive Disorders
- 39. HIV/Hepatitis Co-infection
- 40. Ocular Complications
- 41. Cardiovascular Disease
- 42. Renal Complications
- 43. Musculoskeletal Complications of HIV
- 44. Sexually Transmitted Diseases
- 45. HIV and Bone Health
- 46. HIV-Associated Lipodystrophy and Lipoatrophy
- 47. Dyslipidemia
- 48. Immune Reconstitution Inflammatory Syndrome
- 49. US Health Care Systems, HIV Programs, and Coverage Policy Issues
- 50. Legal Issues<sup>a</sup>
- 51. Research Design and Analysis
- 52. Ethical Conduct of Clinical Trials, Institutional Review Boards, Informed Consent, and Financial Conflicts of Interest
- Index