HIV Associated Neurocognitive Disorder (HAND)

Original Editor - Blessed Denzel Vhudzijena

Top Contributors - Melissa Coetsee, Blessed Denzel Vhudzijena and Kim Jackson  

This article or area is currently under construction and may only be partially complete. Please come back soon to see the finished work! (23/03/23)

Introduction

People living HIV have a chance of developing a range of cognitive, motor, and/or mood problems collectively known as HIV-Associated Neurocognitive Disorder (HAND). Although severe and progressive neurocognitive impairment has become rare in HIV clinics in the era of potent antiretroviral therapy, most patients with HIV worldwide have poor outcomes on formal neurocognitive tests. Typical symptoms include difficulties with attention, concentration, and memory; loss of motivation; irritability; depression; and slowed movements.

Initially it was known as AIDS Dementia Complex, HAND is categorized into three levels of functional impairment. Asymptomatic Neurocognitive Impairment (ANI) is a mild form of HAND with impaired performance on neuropsychological tests, but affected individuals report independence in performing everyday functions. Mild Neurocognitive Disorder (MND) is a common form of HAND that mildly interferes with everyday function. In its most severe form, HAND can manifest as HIV-Associated Dementia (HAD), where there is an inability to complete daily tasks independently. Among HIV infected patients cognitive impairment was and is one of the most feared complications of HIV infection with neuropsychological studies confirming that cognitive impairment occurs in a substantial (15–50%) proportion of patients. In addition, neurocognitive impairment may affect adherence to treatment and ultimately result in increased morbidity for systemic disease. HAND is not necessarily a progressive disorder that worsens with time.