TY - JOUR
T1 - The burden of HIV-associated neurocognitive disorder (HAND) in the Asia-Pacific region and recommendations for screening
AU - Ian, Everall
AU - Gwen, Chan Lai
AU - Soo, Chow Ting
AU - Melissa, Corr
AU - Chun-Kai, Huang
AU - Eosu, Kim
AU - Hyo-Youl, Kim
AU - Asad, Khan
AU - Scott, Letendre
AU - Chung-Ki, Li Patrick
AU - Anekthananon, Thanomsak
AU - Jordan, Treisman Glenn
AU - Han-Ting, Wei
AU - Wing-Wai, Wong
N1 - Publisher Copyright:
© 2015 Elsevier B.V.
PY - 2016/8/1
Y1 - 2016/8/1
N2 - Background HIV-associated neurocognitive disorder incurs a significant burden on HIV patients in Asia-Pacific countries; however, the incidence is difficult to estimate due to a lack of local epidemiological data. The impact of neurocognitive impairment in HIV patients is often underestimated due to a lack of education and awareness, and there are consequently gaps in the provision of screening and diagnosis to enable earlier intervention to limit neurocognitive impairment. Method This review seeks to redress the imbalance by promoting awareness and education among physicians concerning the neurovirulence of HIV and thereby increase screening efforts to improve diagnosis rates and clinical outcomes for underserved patients in this region. The Asia, Australia, and Middle East (AAME) HAND Advisory Board convened expert regional representatives to review current practice and recommend appropriate measures related to the implementation of standardised screening programmes and treatment recommendations to curb the developing HAND epidemic in the region. In particular, we recommend basic neuropsychological testing protocols that could be efficiently introduced into clinical practice for routine screening. Result We also propose simple guidelines for the management of HAND. We believe that HAND is a significant and under-reported diagnosis in HIV patients that warrants both greater recognition and further clinical investigation of the underlying pathophysiology and the impact of HIV disease progression, with HAND being associated with worse medication adherence and therefore possibly increased risk of ARV treatment failure. Discussion Widespread screening will lead to greater recognition of HAND and earlier intervention, which may lead to improved management strategies in the future.
AB - Background HIV-associated neurocognitive disorder incurs a significant burden on HIV patients in Asia-Pacific countries; however, the incidence is difficult to estimate due to a lack of local epidemiological data. The impact of neurocognitive impairment in HIV patients is often underestimated due to a lack of education and awareness, and there are consequently gaps in the provision of screening and diagnosis to enable earlier intervention to limit neurocognitive impairment. Method This review seeks to redress the imbalance by promoting awareness and education among physicians concerning the neurovirulence of HIV and thereby increase screening efforts to improve diagnosis rates and clinical outcomes for underserved patients in this region. The Asia, Australia, and Middle East (AAME) HAND Advisory Board convened expert regional representatives to review current practice and recommend appropriate measures related to the implementation of standardised screening programmes and treatment recommendations to curb the developing HAND epidemic in the region. In particular, we recommend basic neuropsychological testing protocols that could be efficiently introduced into clinical practice for routine screening. Result We also propose simple guidelines for the management of HAND. We believe that HAND is a significant and under-reported diagnosis in HIV patients that warrants both greater recognition and further clinical investigation of the underlying pathophysiology and the impact of HIV disease progression, with HAND being associated with worse medication adherence and therefore possibly increased risk of ARV treatment failure. Discussion Widespread screening will lead to greater recognition of HAND and earlier intervention, which may lead to improved management strategies in the future.
KW - Antiretroviral therapy (ART)
KW - HIV-associated neurocognitive disorders (HAND)
KW - Human immunodeficiency virus (HIV)
KW - Neuropsychological testing
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U2 - 10.1016/j.ajp.2015.10.009
DO - 10.1016/j.ajp.2015.10.009
M3 - Review article
C2 - 26617385
AN - SCOPUS:84947976438
SN - 1876-2018
VL - 22
SP - 182
EP - 189
JO - Asian Journal of Psychiatry
JF - Asian Journal of Psychiatry
ER -