Treatment of HIV-Associated Neurocognitive Disorder: Antiretroviral Therapy Targeting CNS Viral Suppression

In HIV-associated neurocognitive disorder (HAND), treatment must address viral replication in both the systemic circulation and the CNS compartment. Antiretroviral therapy (ART) is the primary intervention, and its initiation is recommended as early as possible after HIV diagnosis to prevent the development or progression of HAND.

Treatment Approach

ART is the cornerstone of management. Drug selection takes into account an agent's capacity to penetrate the blood-brain barrier and act within the CNS compartment. The specific agents, sequencing, and full regimen criteria are detailed in the structured protocol →

Clinical Goals

Achievement and maintenance of HIV viral suppression, with reduced HIV replication in both the systemic and CNS compartments.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1097/MD.0000000000035652

ART remains the cornerstone of the treatment of HAND.
ART aims to achieve and maintain viral suppression, reducing the replication of HIV in both the systemic and CNS compartments.
Some antiretroviral drugs have better penetration into the CNS. These drugs, such as efavirenz or raltegravir, are designed to cross the BBB more effectively, which is crucial for targeting the virus within the CNS.
Initiating ART as early as possible after HIV diagnosis is recommended to prevent the development or progression of HAND.

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