The Evolution of Assessing Central Nervous System Complications in Human Immunodeficiency Virus: Where Do We Go From Here?

Roger C McIntosh; Uraina S Clark; Mariana Cherner; Lucette A Cysique; Robert K Heaton; Jules Levin; Robert H Remien; April Thames; David J Moore; Leah H Rubin

doi:10.1093/infdis/jiac316

The Evolution of Assessing Central Nervous System Complications in Human Immunodeficiency Virus: Where Do We Go From Here?

J Infect Dis. 2023 Mar 17;227(Suppl 1):S30-S37. doi: 10.1093/infdis/jiac316.

Authors

Affiliations

¹ Department of Psychology, University of Miami, Miami, Florida, USA.
² Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
³ Department of Psychiatry, University of California, San Diego, California, USA.
⁴ Department of Psychology, University of New South Wales, Sydney, Australia.
⁵ MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada.
⁶ National AIDS Treatment Advocacy Project, New York, New York, USA.
⁷ Department of Psychiatry, Columbia University, New York, New York, USA.
⁸ Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, California, USA.
⁹ Departments of Neurology, Psychiatry and Behavioral Sciences, Epidemiology, and Molecular and Comparative Pathology, Johns Hopkins University, Baltimore, Maryland, USA.

Abstract

In this fifth decade of the human immunodeficiency virus (HIV) epidemic, central nervous system (CNS) complications including cognitive impairment and mental health remain a burden for people with HIV (PWH) on antiretroviral therapy. Despite the persistence of these complications, which often co-occur, the underlying pathophysiology remains elusive and consequently treatments remain limited. To continue to grow our understanding of the underlying mechanisms of CNS complications among PWH, there is a need to reexamine our current approaches, which are now more than 2 decades old. At the 2021 National Institutes of Health-sponsored meeting on Biotypes of CNS Complications in PWH, the Neurobehavioral Working Group addressed the following: (1) challenges inherent to determining CNS complications; (2) heterogeneity in CNS complications; and (3) problems and solutions for examining integrated biotypes. The review below provides a summary of the main points presented and discussed by the Neurobehavioral Working Group at the meeting.

Keywords: cognitive dysfunction; comorbidity; human immunodeficiency virus; neuropsychological testing; psychosocial factors.

Publication types

Research Support, N.I.H., Extramural

MeSH terms

Central Nervous System
HIV Infections* / complications
HIV Infections* / drug therapy
HIV*
Humans

Abstract

Publication types

MeSH terms

Grants and funding