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Considerations on nosology for HIV-associated neurocognitive disorders: it is time to update?

  • Nicoletta CiccarelliEmail author
Review
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Abstract

Aims

The prognosis and the clinical manifestations of HIV infection have changed with the introduction of the potent combination antiretroviral therapy (cART); however, up to 50% of patients meet research criteria for “HIV-associated neurocognitive disorders” (HAND) according with current nosology. The majority of patients affected by HAND, especially in cohorts with suppressed plasma viremia, showed an Asymptomatic Neurocognitive Impairment (ANI), without any functional impairment. After more than 10 years from the introduction of the current so-called “Frascati criteria”, this mini-review aimed to address the emerging limitations in current diagnosis procedures.

Methods

We discussed the most relevant literature on HAND prevalence, etiology, and diagnosis.

Results

We addressed three main emerging issues: (1) the unclear clinical relevance of ANI entity; (2) the evidences that Frascati criteria could produce a significant overestimation of HAND; (3) the need to better identify patients with a higher risk to develop HAND requiring routine neuropsychological examinations.

Conclusions

Frascati criteria should be updated to better respond to the present characteristics of HIV + cohorts and to help clinicians in their cognitive and global management.

Keywords

HIV HIV-associated neurocognitive disorders Nosology Risk factors 

Notes

Compliance with ethical standards

Conflict of interest

The author declares that they have no competing interests.

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© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of PsychologyCatholic UniversityMilanItaly

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