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AIDS Care
Psychological and Socio-medical Aspects of AIDS/HIV
Volume 26, 2014 - Issue 2
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ORIGINAL ARTICLES

Screening for HIV-related neurocognitive impairment in clinical practice: Challenges and opportunities

T.J. BarberSt. Stephen's Centre, Chelsea and Westminster Hospital NHS Foundation Trust, London, UKCorrespondence[email protected]
,
D. BradshawSt. Stephen's Centre, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK;The Kirby Institute for Infection and Immunity in Society, University of New South Wales, Sydney, NSW, Australia
,
D. HughesImperial College London, London, UK
,
L. LeonidouSt. Stephen's Centre, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK;Department of Infectious Diseases, Patras University Hospital, Patras, Greece
,
A. MargettsSouth Kensington and Chelsea Mental Health Centre, Central and North West London NHS Foundation Trust, London, UK
,
D. RatcliffeSouth Kensington and Chelsea Mental Health Centre, Central and North West London NHS Foundation Trust, London, UK
,
S. ThorntonSouth Kensington and Chelsea Mental Health Centre, Central and North West London NHS Foundation Trust, London, UK
,
A. PozniakSt. Stephen's Centre, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
,
D. AsboeSt. Stephen's Centre, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
,
S. MandaliaImperial College London, London, UK
,
M. BoffitoSt. Stephen's Centre, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
,
N. DaviesDepartment of Neurology, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
,
B. GazzardSt. Stephen's Centre, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
&
J. CatalanSouth Kensington and Chelsea Mental Health Centre, Central and North West London NHS Foundation Trust, London, UK
 show all
Pages 160-168 | Received 25 Sep 2012, Accepted 20 Jun 2013, Published online: 22 Jul 2013
 
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Abstract

With increasingly successful management of HIV, focus has shifted away from AIDS-related complications to other chronic co-morbidities. For HIV-related cognitive problems, the true aetiopathogenesis and epidemiology remains unclear. Rather than a systematic review, this paper presents the challenges and the opportunities we faced in establishing our own clinical service. Papers were identified using Pubmed and the terms “screening”, “HIV” and “neurocognitive”. This article covers the background of HIV-associated neurocognitive disorders (HAND) with a focus on HIV-related neurocognitive impairment (NCI), detailing classification, prevalence, diagnostic categories and diagnostic uncertainties. Screening is discussed, including a comparison of the available screening tools for cognitive deficits in HIV-infected patients and the importance of practice effects. Discussed also are the normal ranges and the lack thereof and potential investigations for those found to have impairments. We conclude by discussing the role of NCI screening in routine clinical care at the current time.

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