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The burden of HIV-associated neurocognitive disorder (HAND) in the Asia-Pacific region and recommendations for screening

Authors
 Everall Ian  ;  Chan Lai Gwen  ;  Chow Ting Soo  ;  Corr Melissa  ;  Huang Chun-Kai  ;  Kim Eosu  ;  Kim Hyo-Youl  ;  Khan Asad  ;  Letendre Scott  ;  Li Patrick Chung-Ki  ;  Thanomsak Anekthananon  ;  Treisman Glenn Jordan  ;  Wei Han-Ting  ;  Wong Wing-Wai 
Citation
 Asian Journal of Psychiatry, Vol.22 : 182-189, 2016 
Journal Title
 Asian Journal of Psychiatry 
ISSN
 1876-2018 
Issue Date
2016
Keywords
Antiretroviral therapy (ART) ; HIV-associated neurocognitive disorders (HAND) ; Human immunodeficiency virus (HIV) ; Neuropsychological testing
Abstract
BACKGROUND: HIV-associated neurocognitive disorder incurs a significant burden on HIV patients in Asia-Pacific countries; however, the incidence is difficult to estimate due to a lack of local epidemiological data. The impact of neurocognitive impairment in HIV patients is often underestimated due to a lack of education and awareness, and there are consequently gaps in the provision of screening and diagnosis to enable earlier intervention to limit neurocognitive impairment. METHOD: This review seeks to redress the imbalance by promoting awareness and education among physicians concerning the neurovirulence of HIV and thereby increase screening efforts to improve diagnosis rates and clinical outcomes for underserved patients in this region. The Asia, Australia, and Middle East (AAME) HAND Advisory Board convened expert regional representatives to review current practice and recommend appropriate measures related to the implementation of standardised screening programmes and treatment recommendations to curb the developing HAND epidemic in the region. In particular, we recommend basic neuropsychological testing protocols that could be efficiently introduced into clinical practice for routine screening. RESULT: We also propose simple guidelines for the management of HAND. We believe that HAND is a significant and under-reported diagnosis in HIV patients that warrants both greater recognition and further clinical investigation of the underlying pathophysiology and the impact of HIV disease progression, with HAND being associated with worse medication adherence and therefore possibly increased risk of ARV treatment failure. DISCUSSION: Widespread screening will lead to greater recognition of HAND and earlier intervention, which may lead to improved management strategies in the future.
DOI
10.1016/j.ajp.2015.10.009
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Psychiatry (정신과학교실) > 1. Journal Papers
Yonsei Authors
김어수(Kim, Eosu) ORCID logo https://orcid.org/0000-0001-9472-9465
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/165785
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