HIV-associated neurocognitive disorder - Revision history

Aidan: /* Differential Diagnosis */ links

2026-03-17T17:19:20Z

Differential Diagnosis: links

← Older revision		Revision as of 17:19, 17 March 2026
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	* CNS viral escape, with CSF HIV viral load compared to simultaneous plasma viral load		* CNS viral escape, with CSF HIV viral load compared to simultaneous plasma viral load
	* Primary CNS lymphoma		* [[Primary CNS lymphoma]]
	* Progressive multifocal leukoencephalopathy caused by JC virus		* [[Progressive multifocal leukoencephalopathy]] caused by [[JC virus]]
	* Cryptococcus		* [[Cryptococcus]]
	* Toxoplasma		* [[Toxoplasma]]
	* Obstructive sleep apnea		* [[Obstructive sleep apnea]]
	* Low vitamin B12		* Low vitamin B12
	* Thyroid disease		* Thyroid disease
	* Syphilis		* [[Syphilis]]
	* Other causes of cognitive impairment unrelated to HIV, including subclinical depression, drug use, educational deprivation, socioeconomic status, and Alzheimer dementia		* Other causes of cognitive impairment unrelated to [[HIV]], including subclinical depression, drug use, educational deprivation, socioeconomic status, and [[Alzheimer dementia]]

	== Diagnostic Criteria ==		== Diagnostic Criteria ==

Aidan: /* Differential Diagnosis */

2021-06-23T18:46:14Z

Differential Diagnosis

← Older revision		Revision as of 18:46, 23 June 2021
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	== Differential Diagnosis ==		== Differential Diagnosis ==

	* ~~Must rule out~~ CNS viral escape with CSF HIV viral load compared to simultaneous plasma viral load		* CNS viral escape, with CSF HIV viral load compared to simultaneous plasma viral load
			* Primary CNS lymphoma
			* Progressive multifocal leukoencephalopathy caused by JC virus
			* Cryptococcus
			* Toxoplasma
	* Obstructive sleep apnea		* Obstructive sleep apnea
	* Low vitamin B12		* Low vitamin B12

Aidan: Created page with "== Background == * Previously called AIDS dementia complex === Epidemiology === * Severe HAND less common following ART * First factors include lack of viral suppression, l..."

2021-06-23T18:44:20Z

Created page with "== Background == * Previously called AIDS dementia complex === Epidemiology === * Severe HAND less common following ART * First factors include lack of viral suppression, l..."

New page

== Background ==

* Previously called AIDS dementia complex

=== Epidemiology ===

* Severe HAND less common following ART
* First factors include lack of viral suppression, low nadir CD4 count, and increasing age
* Other risk factors include [[hypertension]], [[dyslipidemia]], [[diabetes]], and coinfections such as [[hepatitis C]]

== Clinical Manifestations ==

* Spectrum that includes asymptomatic neurocongitive impairment (impairment only noted on formal tests), mild neurocognitive disorder (affects functioning), and HIV-associated dementia (inability to perform ADLs)
* Not necessarily progressive
* Wide range of symptoms, including inattention, poor concentration, irritability, apathy, mood changes, motor dysfunction
* Head imaging often shows global atrophy

== Differential Diagnosis ==

* Must rule out CNS viral escape with CSF HIV viral load compared to simultaneous plasma viral load
* Obstructive sleep apnea
* Low vitamin B12
* Thyroid disease
* Syphilis
* Other causes of cognitive impairment unrelated to HIV, including subclinical depression, drug use, educational deprivation, socioeconomic status, and Alzheimer dementia

== Diagnostic Criteria ==

* Uses the Frascati criteria 2007
* Based on formal assessment of at least five neurocognitive domains, including attention-information processing, language, abstraction-executive, complex perceptual motor skills, memory including learning and recall, simple motor skills or sensory perceptual skills
* Exclusion of other causes

{| class="wikitable"
!
!Neurocognitive Status
!Functional Status
|-
|Asymptomatic neurocognitive impairment
| rowspan="2" |1 SD below mean in 2 cognitive domains
|no impairment in activities of daily living
|-
|Mild neurocognitive disorder
|impairment in activities of daily living
|-
|HIV-associated dementia
|2 SD below mean in 2 cognitive domains
|marked impairment in activities of daily living
|}
[[Category:HIV]]