Original Research

HIV-associated neurocognitive disorders

Zahir Vally
South African Journal of Psychiatry | Vol 17, No 4 | a294 | DOI: https://doi.org/10.4102/sajpsychiatry.v17i4.294 | © 2011 Zahir Vally | This work is licensed under CC Attribution 4.0
Submitted: 18 March 2011 | Published: 01 December 2011

About the author(s)

Zahir Vally, Department of Psychiatry and Mental Health, University of Cape Town and Lentegeur Psychiatric Hospital, Mitchell’s Plain, W Cape, and Winnicott Research Centre, School of Psychology and Clinical Language Sciences, University of Reading, UK, South Africa

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HIV infection is associated with disturbances in brain function referred to as HIV-associated neurocognitive disorders (HAND). This literature review outlines the recently revised diagnostic criteria for the range of HAND from the earliest to the more advanced stages: (i) asymptomatic neurocognitive impairment; (ii) mild neurocognitive disorder; and (iii) HIV-associated dementia. Relevant literature is also reviewed regarding the differential impact upon component cognitive domains known to be affected in HAND, which in turn should ideally be targeted during clinical and neuropsychological assessments: psychomotor and information processing speed, learning and memory, attention and working memory, speech and language, executive functioning and visuospatial functioning. A discussion outlining the neuropsychological tools used in the diagnostic screening of HAND is also included. The central mechanisms of HAND appear to revolve primarily around psychomotor slowing and cognitive control over mental operations, possibly reflecting the influence of disrupted fronto-striatal circuits on distributed neural networks critical to cognitive functions. The accurate assessment and diagnosis of HAND depends on meeting the need for statistically sound neuropsychological assessment techniques that may be used confidently in assessing South African populations, as well as the development of relevant norms for comparison of test performance data.


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