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HIV, Antiretroviral Therapies, and the Brain

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Abstract

While combination antiretroviral therapy (CART) has decreased the incidence of HIV-associated dementia, the severest form of HIV-associated neurocognitive disorders (HAND), mild neurocognitive disorder and asymptomatic neurocognitive impairment continue to persist, and there is evidence that neurocognitive deficits present even in acute HIV infection. Recent studies demonstrate that CART regimens with higher central nervous system (CNS) penetration effectiveness ranks may improve neurocognitive functioning. Considering these factors, earlier treatment initiation may be considered to protect the CNS. The functional impact of HAND on daily activities should be monitored. Areas that need further research are potential neurotoxicity of antiretrovirals, the eradication of potential latent reservoirs in the brain, when to start treatment to protect the CNS, and the neurological impact of HIV on the CNS in acute infection.

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Disclosure

Dr. Robertson has received honoraria from or consulted for Abbott, GlaxoSmithKline, and Boehringer-Ingelheim. No other potential conflicts of interest relevant to this article were reported.

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  1. Department of Neurology, University of North Carolina, 2127 Physician Office Building, 170 Manning Drive, Chapel Hill, NC, 27599-7025, USA

    Kevin J. Liner II, Michelle J. Ro & Kevin R. Robertson

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  1. Kevin J. Liner II
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  2. Michelle J. Ro
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  3. Kevin R. Robertson
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Correspondence to Kevin R. Robertson.

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Liner, K.J., Ro, M.J. & Robertson, K.R. HIV, Antiretroviral Therapies, and the Brain. Curr HIV/AIDS Rep 7, 85–91 (2010). https://doi.org/10.1007/s11904-010-0042-8

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