Interactions between ageing and NeuroAIDS.

Abstract

The purpose of this study is to summarize recent advances in ageing and neuroAIDS by reviewing relevant articles from the preceding 18 months from PubMed and PsycINFO databases. The success of combination antiretroviral therapy (cART) has led to ageing of the HIV-infected population, which in turn contributes to the prevalence of HIV-associated neurocognitive disorder (HAND). Biomedical advances continue to clarify the pathophysiology of HAND despite effective cART, including chronic inflammatory and neurovascular causes. In recent months, associations between HAND and nonneurological medical diseases have been identified, as well as linkage to neuroimaging in those ageing with HIV. Developing effective screening tools to detect impairment remains an important scientific gap, although promoting factors associated with successful cognitive ageing is emerging as a possible means of enhancing quality of life. A greater understanding of HAND pathophysiology among treated individuals with suppressed virus will aid in explaining the high prevalence of HAND despite effective cART and allow for development of novel targeted interventions. Neuroimaging and other biomarkers show promise in discerning HAND from age-associated cognitive disorders. Effective screening tools remain critically needed. Together, this work will inform promising strategies needed to address issues pertinent to an expanding group of older patients living with HIV.