Nicoletta Ciccarelli1. 1. Department of Psychology, Catholic University, Largo Agostino Gemelli 1, 20123, Milan, Italy. nicoletta.ciccarelli@gmail.com.
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.
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.
Authors: Anna Prats; Ignacio Martínez-Zalacaín; Beatriz Mothe; Eugènia Negredo; Núria Pérez-Álvarez; Maite Garolera; Sira Domènech-Puigcerver; Pep Coll; Michael Meulbroek; Anna Chamorro; Carmina R Fumaz; Maria J Ferrer; Bonaventura Clotet; Carles Soriano-Mas; Jose A Muñoz-Moreno Journal: Sci Rep Date: 2021-05-28 Impact factor: 4.379