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Cognitive impairmen...
Cognitive impairment in people living with HIV: consensus recommendations for a new approach
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Nightingale, S. (author)
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Ances, B. (author)
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Cinque, P. (author)
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Dravid, A. (author)
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Dreyer, A. J. (author)
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- Gisslén, Magnus, 1962 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för biomedicin, avdelningen för infektionssjukdomar,Institute of Biomedicine, Department of Infectious Medicine
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Joska, J. A. (author)
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Kwasa, J. (author)
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Meyer, A. C. (author)
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Mpongo, N. (author)
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Nakasujja, N. (author)
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Pebody, R. (author)
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Pozniak, A. (author)
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Price, R. W. (author)
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Sandford, C. (author)
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Saylor, D. (author)
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Thomas, K. G. F. (author)
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Underwood, J. (author)
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Vera, J. H. (author)
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Winston, A. (author)
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(creator_code:org_t)
- 2023
- 2023
- English.
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In: Nature Reviews Neurology. - 1759-4758. ; 19:7, s. 424-433
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Abstract
Subject headings
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- Current approaches to classifying cognitive impairment in people living with HIV can overestimate disease burden and lead to ambiguity around disease mechanisms. In this Consensus Statement, the International HIV-Cognition Working Group have outlined six recommendations towards a new approach, intended to better represent changes in the spectrum of HIV disease in the modern era of antiretroviral therapy. Current approaches to classifying cognitive impairment in people living with HIV can overestimate disease burden and lead to ambiguity around disease mechanisms. The 2007 criteria for HIV-associated neurocognitive disorders (HAND), sometimes called the Frascati criteria, can falsely classify over 20% of cognitively healthy individuals as having cognitive impairment. Minimum criteria for HAND are met on the basis of performance on cognitive tests alone, which might not be appropriate for populations with diverse educational and socioeconomic backgrounds. Imprecise phenotyping of cognitive impairment can limit mechanistic research, biomarker discovery and treatment trials. Importantly, overestimation of cognitive impairment carries the risk of creating fear among people living with HIV and worsening stigma and discrimination towards these individuals. To address this issue, we established the International HIV-Cognition Working Group, which is globally representative and involves the community of people living with HIV. We reached consensus on six recommendations towards a new approach for diagnosis and classification of cognitive impairment in people living with HIV, intended to focus discussion and debate going forward. We propose the conceptual separation of HIV-associated brain injury - including active or pretreatment legacy damage - from other causes of brain injury occurring in people living with HIV. We suggest moving away from a quantitative neuropsychological approach towards an emphasis on clinical context. Our recommendations are intended to better represent the changing profile of cognitive impairment in people living with HIV in diverse global settings and to provide a clearer framework of classification for clinical management and research studies.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Medicinska och farmaceutiska grundvetenskaper -- Neurovetenskaper (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Basic Medicine -- Neurosciences (hsv//eng)
Keyword
- reconstitution inflammatory syndrome
- human-immunodeficiency-virus
- central-nervous-system
- neurocognitive disorders
- antiretroviral
- treatment
- neuronal injury
- viral escape
- risk
- prevalence
- infection
- Neurosciences & Neurology
Publication and Content Type
- ref (subject category)
- art (subject category)
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To the university's database
- By the author/editor
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Nightingale, S.
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Ances, B.
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Cinque, P.
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Dravid, A.
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Dreyer, A. J.
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Gisslén, Magnus, ...
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show more...
-
Joska, J. A.
-
Kwasa, J.
-
Meyer, A. C.
-
Mpongo, N.
-
Nakasujja, N.
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Pebody, R.
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Pozniak, A.
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Price, R. W.
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Sandford, C.
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Saylor, D.
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Thomas, K. G. F.
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Underwood, J.
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Vera, J. H.
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Winston, A.
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show less...
- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Basic Medicine
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and Neurosciences
- Articles in the publication
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Nature Reviews N ...
- By the university
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University of Gothenburg