Assessment and Diagnosis of HIV-Associated Dementia

HIV infection has long been known to result in dementia and other forms of neurocognitive deficits. The rate of HIV-associated dementia is decreasing, while mild forms of neurological impairments increase. Treatment of HIV infection has advanced, and patients are living longer, and are thus at a greater risk of cognitive decline. The HIV aging cohort is susceptible to neurocognitive impairment from other medical conditions that have a compounding effect on cognitive decline. The diagnosis of HIV-associated neurocognitive disorders involves identifying neurological dysfunction and then determining that HIV is the most probable cause. Implications for practice include early control of HIV replication and treatment of comorbid diseases. •HIV associated neurocognitive disorder (HAND) affects patients’ quality of life.•HIV-related dementia is decreasing, while mild HAND increases.•cART has increased survival of PLWH, thus at a greater risk of cognitive decline.•Treatment of HIV of comorbid disease can decrease risk of cognitive impairment.•Hepatitis C treatment should be offered absent of contraindications.