Assessment, Diagnosis, and Treatment of HIV-Associated Neurocognitive Disorder: A Consensus Report of the Mind Exchange Program

被引：143

作者：

Antinori, Andrea ^{[1
]}

Arendt, Gabriele ^{[2
]}

Grant, Igor ^{[3
,4
]}

Letendre, Scott ^{[3
,5
]}

Munoz-Moreno, Jose A. ^{[6
]}

机构：

[1] Natl Inst Infect Dis, Rome, Italy

[2] Univ Klinikum Dusseldorf, Dept Neurol, Dusseldorf, Germany

[3] Univ Calif San Diego, HIV Neurobehav Res Program, San Diego, CA 92103 USA

[4] Univ Calif San Diego, Dept Psychiat, San Diego, CA 92103 USA

[5] Univ Calif San Diego, Div Infect Dis, San Diego, CA 92103 USA

[6] Germans Trias & Pujol Univ Hosp, Lluita SIDA Fdn, Barcelona, Spain

来源：

CLINICAL INFECTIOUS DISEASES | 2013年 / 56卷 / 07期

关键词：

AIDS dementia complex; HIV-associated dementia (HAD); HIV-associated neurocognitive disorder (HAND); HIV encephalopathy; neurocognitive impairment; ACTIVE ANTIRETROVIRAL THERAPY; MULTICENTER AIDS COHORT; INFECTED ADULTS; DEMENTIA SCALE; RISK-FACTORS; NEUROPSYCHOLOGICAL PERFORMANCE; TREATMENT INTERRUPTION; COGNITIVE FUNCTION; POSITIVE PATIENTS; SCREENING TOOL;

D O I：

10.1093/cid/cis975

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

摘要：

Many practical clinical questions regarding the management of human immunodeficiency virus (HIV)-associated neurocognitive disorder (HAND) remain unanswered. We sought to identify and develop practical answers to key clinical questions in HAND management. Sixty-six specialists from 30 countries provided input into the program, which was overseen by a steering committee. Fourteen questions were rated as being of greatest clinical importance. Answers were drafted by an expert group based on a comprehensive literature review. Sixty-three experts convened to determine consensus and level of evidence for the answers. Consensus was reached on all answers. For instance, good practice suggests that all HIV patients should be screened for HAND early in disease using standardized tools. Follow-up frequency depends on whether HAND is already present or whether clinical data suggest risk for developing HAND. Worsening neurocognitive impairment may trigger consideration of antiretroviral modification when other causes have been excluded. The Mind Exchange program provides practical guidance in the diagnosis, monitoring, and treatment of HAND.

引用

页码：1004 / 1017

页数：14

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