Incidence, risk factors, and pathogenic mechanism of neurocognitive disorders (HAND) among HIV-1-infected subjects

Abstract

The prognosis of HAND presents a difficult approach, especially in the first stage of the disease, which may prevent early treatment and prevention of more severe forms. HIV can remain latent in the CNS for many years and subclinical infection associated with comorbidities (e.g., metabolic syndrome, drug use and Hepatitis C), as well as lead to immune activation, and low-grade chronic immune inflammation. Immunological effects and the possibility of developing neurocognitive changes due to HIV infection are not ruled out, despite the suppression of viral RNA in peripheral blood and cerebrospinal fluid (CSF). Some authors argue that a higher rate of drug penetration (CPE) in the CNS could be associated with a greater chance of undetectable viral load in the CNS, as well as better cognitive functioning. This proposal aims to combine several previous studies that describe virological and immunological factors that could be considered as potential markers for diagnosis as well as more recently identified factors. (AU)