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'''HIV-associated neurocognitive impairments'''
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[[HIV]]
 
 
''Revised research criteria for HIV-associated neurocognitive disorders (HAND)'' (Antinori et al, 2007)
 
 
 
1) HIV-associated asymptomatic neurocognitive impairment (ANI)
 
 
 
: a. Acquired impairment in cognitive functioning, involving at least two domains, documented by performance of at least 1.0 SD below the mean for age-education appropriate norms
 
 
 
: b. Cognitive impairment does not interfere with everyday functioning
 
 
 
: c. Cognitive impairment does not meet criteria for delirium or dementia
 
 
 
: d. There is no evidence of another preexisting cause for the ANI
 
 
 
2) HIV-associated mild neurocognitive disorder (MND)
 
 
 
:a. Acquired impairment in cognitive functioning, involving at least two domains, documented by performance of at least 1.0 SD below the mean for age-education appropriate norms
 
 
 
:b. The cognitive impairment produces at least mild interference in daily functioning, at least one of the following:
 
 
 
::i. Self-report of reduced mental acuity, inefficiency in work, homemaking, or social functioning
 
 
 
::ii. Observation by knowledgeable others that the individual has undergone at least mild decline in mental acuity with resultant inefficiency in work, homemaking, or social functioning
 
 
 
:c. The cognitive impairment does not meet criteria for delirium or dementia
 
 
 
:d. There is no evidence of another preexisting cause for the MND
 
 
 
::i. If there is a prior diagnosis of MND, but currently the individual does not meet criteria, the diagnosis of MND in remission can be made
 
 
 
::ii. If the individual with suspected MND also satisfies criteria for a severe episode of major depression with significant functional limitations or psychotic features, or substance dependence, the diagnosis of MND should be deferred to subsequent examination conducted at a time when the depression has remitted or at least 1 month after cessation of substance use
 
 
 
3) HIV-1-associated dementia (HAD)
 
 
 
:a. Marked acquired impairment in cognitive functioning involving at least two domains; typically, the impairment is in multiple domains, especially in learning of new information, slowed information processing, and defective attention/concentration, documented by performance of at least 2.0 SD below the mean for age-education appropriate norms
 
 
 
:b. The cognitive impairment produces marked interference with day-to-day functioning (work, home life, social activities)
 
 
 
:c. The pattern of cognitive impairment does not meet criteria for delirium, or if delirium is present, criteria for dementia need to have been met on prior examination without delirium present
 
 
 
:d. There is no evidence of another, preexisting cause for the dementia (CNS infection, CNS neoplasm, CVD, preexisting neurologic disease, or severe substance abuse)
 
 
 
::i. If there is a prior diagnosis of HAD, but currently the individual does not meet criteria, the diagnosis of HAD in remission can be made
 
 
 
::ii. If the individual with suspected HAD also satisfies criteria for a severe episode of major depression with significant functional limitations or psychotic features, or substance dependence, the diagnosis of HAD should be deferred to subsequent examination conducted at a time when the depression has remitted or at least 1 month after cessation of substance use
 
 
 
 
 
 
 
== References ==
 
 
 
Antinori, A. et al. Updated research nosology for HIV-associated neurocognitive disorders. Neurology 69, 1789–1799 (2007). https://pubmed.ncbi.nlm.nih.gov/17914061/
 

Latest revision as of 22:22, 12 June 2021