Diagnosis Of HIV-associated Neurocognitive Disorders Research Articles

Diagnosis of HIV-associated Neurocognitive Disorder (HAND) in Latin America: A Scoping Review (P9-13.002)

Diagnosis of HIV-associated Neurocognitive Disorder (HAND) in Latin America: A Scoping Review (P9-13.002)

Age, cognitive status, and accuracy of ADL self-reports in adults living with HIV

ABSTRACT Determination of functional capacity in cognitively impaired persons living with HIV (PLHIV) is pivotal to the accurate diagnosis of HIV-associated neurocognitive disorders (HAND). Functional data is typically collected through self-report. Reliability concerns arise with memory and executive functioning impairments, which could compromise the integrity of self-report and result in inaccurate HAND diagnoses. The current study tested the accuracy of older PLHIV functional reports through examination of concordance rates between self-report and caregiver’s (CG) report. Cross-sectional cognitive, mood, and functional status data were sampled from the Manhattan HIV Brain Bank. Participants and caregivers independently completed an Activities of Daily Living (ADL) questionnaire, producing 78 participant-caregiver dyads. Functional report concordance was operationalized by calculating differences between participant and CG ADL total scores. Assessment pairs differing by 2 or more points were considered to be discordant. Analyses revealed that one-third of the patient sample was discordant in the ADL report. ANOVA revealed that PLHIV overestimating their functional impairments, were significantly older, more educated, and more depressed than other participants. Global cognitive functioning was not associated with concordance. Thus, the majority of PLHIV were consistent with their caregivers’ ADL report, and older age and increased depressive symptomatology, but not cognitive status, were factors associated with discordance.

Plasma Cytokine Biomarker Cutoff Values for HIV-Associated Neurocognitive Impairment in Adults.

Diagnosing HIV-associated neurocognitive impairment in most high-burden, but resource-constrained, settings is difficult due to the unavailability of specialist neurologists and neuropsychologists in primary health care centers. New tests that are easy to perform, based on virological and host immune response biomarkers, may be valuable in the diagnosis of HIV-associated neurocognitive disorder. The receiver operator characteristic curve analysis was used to investigate the diagnostic accuracy of threshold/cutoff concentrations for the peripheral lymphocyte proviral load and plasma biomarkers as diagnostic candidates for neurocognitive impairment in 133 HIV-infected individuals, using global deficit scores as the clinical gold standard. Forty-five (33.83%) of the participants had HIV-associated neurocognitive impairment, with 17.29% being mildly impaired and 16.54% moderately impaired. IL-2 had the best performance as a diagnostic tool for neurocognitive impairment with sensitivity of 67% and specificity of 52%, while the lowest performance was IL-6 with 65% sensitivity and 39% specificity. MIP-1α had the highest precision for the cutoff value, as indicated by the narrow 95% confidence interval (CI) (2.23-3.27), followed by IL-2 with 95% CI (3.02-5.12). RANTES had least precision, as shown by the widest 95% CI (135-9,487.61). For clinical markers of HIV diagnosis and monitoring, the lymphocyte proviral load cutoff value of 145 genome copies/million cells had the highest accuracy with 60% sensitivity and 51% specificity. The plasma viral load had an imperfect balance of 46% sensitivity and 78% specificity. The study demonstrated low to medium diagnostic accuracy of plasma cytokine biomarker cutoff values for defining neurocognitive impairment in people living with HIV.

The clinical and demographic profile of women living with HIV admitted to the acute unit at Stikland Psychiatric Hospital.

BackgroundThere is a paucity of research on the clinical profile of women living with human immunodeficiency virus (HIV) (WLWH) admitted with acute mental health illness. Existing studies are small and did not look at factors that could have an impact on medication adherence. As a first step to inform service delivery for this vulnerable population, a thorough understanding of the composition and needs of these patients should be identified.ObjectivesTo describe the socio-demographic and clinical profile that could have an influence on the antiretroviral therapy (ART) adherence of WLWH at an inpatient psychiatric unit.MethodsIn this retrospective audit, the medical records of all WLWH (18–59 years of age), discharged from the acute unit at Stikland Psychiatric Hospital, were reviewed over a 12-month period.ResultsOf the 347 female patients discharged, 55 patients were positive for HIV (15.9%). The majority of them were unmarried (78.2%), unemployed (92.7%), had a secondary level of education (Grade 8–10) (58.2%), lived with a family member (83.6%) and had children (61.8%). The most common psychiatric diagnosis on discharge was substance use disorder with 78.2% of patients being categorised as substance users. Interpersonal violence was only reported by 5.5% of patients. Although most patients performed poorly on the Montreal Cognitive Assessment (MoCA) and International HIV Dementia Scale (IHDS), only 12% of patients received a diagnosis of HIV-associated neurocognitive disorder (HAND) upon discharge. Antiretroviral therapy (ART) was initiated in 21.8% of patients. Only eight patients had a viral load of < 200 copies/mL, indicating viral suppression.ConclusionOur findings may inform service planning and emphasise the need for targeted intervention strategies to improve treatment outcomes in this vulnerable group.

Neuropsychiatric Disorders, Emotional Disturbances, and Their Associations with HIV-Associated Neurocognitive Disorder.

The current chapter provides a critical and narrative review of recent research on the neuropsychiatric disorders, emotional disturbances, and their associations with neurocognitive functioning in people living with HIV infection. We review a range of neuropsychiatric disorders including depression and anxiety disorders, but also emotional disturbances, which can be partly distinguished from depression and anxiety (apathy, alexithymia, and emotional processing impairment). While reviewing the research into the neuropsychiatric disorders and HIV-associated neurocognitive disorders, we also cover the questions of self-reported cognitive symptoms evaluation and interpretation. The chapter includes research on the role of coping skills, perceived stress and response to stressful life events, and connections to neurocognitive impairment in people living with HIV. Promising non-pharmacological interventions are highlighted. The chapter concludes with the clinical implications on how to best consider neuropsychiatric disorders and cognitive symptoms for the diagnosis of HIV-associated neurocognitive disorders, as well as future research directions.

Connectome-based prediction of global cognitive performance in people with HIV

Global cognitive performance plays an important role in the diagnosis of HIV-associated neurocognitive disorders (HAND), yet to date, there is no simple way to measure global cognitive performance in people with HIV (PWH). Here, we performed connectome-based predictive modeling (CPM) to pursue a neural biomarker of global cognitive performance in PWH based on whole-brain resting-state functional connectivity. We built a CPM model that successfully predicted individual differences in global cognitive performance in the training set of 67 PWH by using leave-one-out cross-validation. This model generalized to both 33 novel PWH in the testing set and a subset of 39 PWH who completed a follow-up visit two years later. Furthermore, network strengths identified by the CPM model were significantly different between PWH with HAND and without HAND. Together, these results demonstrate that whole-brain functional network strengths could serve as a potential neural biomarker of global cognitive performance in PWH.

Reactions to a Probable Diagnosis of HIV-Associated Neurocognitive Disorder: A Content Analysis.

Half of the people living with HIV have cognitive deficits indicative of HIV-associated neurocognitive disorders (HANDs). With few treatment options, informing patients about a HAND diagnosis is a questionable practice. A sample of 139 people living with HIV were administered gold-standard cognitive tests; scores were used to determine whether they met cognitive criteria for HAND. Participants were informed that they met the criteria for HAND and asked 2 open-ended questions about their reactions to learning this information. Participant responses were recorded verbatim and coded into 3 overarching themes: positive, indifferent, and negative. Positive responses contained subthemes of confirmation, gratitude, desire for improvement, and curiosity. Indifferent responses contained nonreactive responses, apathy, and confusion. Negative responses contained surprise, discontentment, fear, and denial. Although most participants responded positively to feedback about HANDs, others experienced distress. Nurse clinicians should be mindful about informing patients if they have HAND while also educating them about brain health.

Automated diagnosis of HIV-associated neurocognitive disorders using large-scale Granger causality analysis of resting-state functional MRI

HIV-associated neurocognitive disorders (HAND) represent an important source of neurologic complications in individuals with HIV. The dynamic, often subclinical, course of HAND has rendered diagnosis, which currently depends on neuropsychometric (NP) evaluation, a challenge for clinicians. Here, we present evidence that functional brain connectivity, derived by large-scale Granger causality (lsGC) analysis of resting-state functional MRI (rs-fMRI) time-series, represents a potential biomarker to address this critical diagnostic need. Brain graph properties were used as features in machine learning tasks to 1) classify individuals as HIV+ or HIV− and 2) to predict overall cognitive performance, as assessed by NP scores, in a 22-subject (13 HIV−, 9 HIV+) cohort. Over nearly all seven brain parcellation templates considered, support vector machine (SVM) classifiers based on lsGC-derived brain graph features significantly outperformed those based on conventional Pearson correlation (PC)-derived features (p<0.05, Bonferroni-corrected). In a second task for which the objective was to predict the overall NP score of each subject, the lsGC-based SVM regressors consistently outperformed the PC-based regressors (p<0.05, Bonferroni-corrected) on nearly all templates. With the widely used Automated Anatomical Labeling (AAL90) template, it was determined that the brain regions that figured most strongly in the SVM classifiers included those of the default mode network (posterior cingulate cortex, angular gyrus) and basal ganglia (caudate nucleus), dysfunction in both of which have been observed in previous structural and functional analyses of HAND.

Cultural Neuropsychology Considerations in the Diagnosis of HIV-Associated Neurocognitive Disorders.

Human Immunodeficiency Virus Type-I (HIV) is a health disparities issue that affects culturally and linguistically diverse (CALD) and underrepresented minority populations to a greater degree than non-Hispanic white populations. Neurologically speaking, CALD populations experience worse HIV-related health outcomes, which are exacerbated by inadequate neurocognitive measures, poor normative samples, and the complex interplay of sociocultural factors that may affect test interpretation. Although cross-cultural neuropsychologists are working diligently to correct this gap in the literature, currently, studies examining neurocognitive outcomes among CALD populations are sparse. The most well-studied CALD groups are of African American/Black and Latinx adults in the US, and the chapter therefore focuses on these studies. There is more limited work among other populations in the US, such as Asians, Native Hawaiians, Pacific Islanders, and American Indians/Alaskan Natives, and even fewer studies for many CALD populations outside of the US. For example, HIV neuropsychology data is rare or nonexistent in the First Peoples of Australia and Indigenous People of Canada. It is often not adequately reported in Europe for the migrant populations within those countries or other world regions that have historically large multicultural populations (e.g., South America, Caribbean countries, Asia, and Africa). Therefore, this chapter reviews HIV-related health disparities faced by CALD populations with focus on North American research where it has been specifically studied, with particular attention given to disparities in HIV-Associated Neurocognitive Disorders (HAND). International data was also included for research with focus on First Peoples of Australia and Indigenous People of Canada. The chapter also examines other sociocultural and health factors, including global and regional (e.g., rural versus urban) considerations, migration, and gender. Further, guidelines for incorporating sociocultural consideration into assessment and interpretation of neurocognitive data and HAND diagnosis when working with HIV-positive CALD populations that would be relevant internationally are provided.

Caregiver versus self-reported activities of daily living among HIV-positive persons in Rakai, Uganda

ABSTRACTAssessment of an individual’s functional status, as measured by activities of daily living (ADL), is an essential element in the diagnosis of HIV-associated neurocognitive disorders (HAND) but individuals with cognitive impairment may not accurately report ADL. We assessed agreement between self- and caregiver-reported ADL in HIV-positive persons. Antiretroviral therapy (ART)-naïve HIV-positive persons (n = 321) and HIV-negative controls (n = 134) in Rakai, Uganda, completed neurocognitive tests and an ADL questionnaire. Co-resident relatives (“caregivers”) were independently administered the ADL questionnaire to determine their perception of the participant’s ADL. The relationship between neurocognitive impairment and participant-caregiver agreement was assessed using kappa statistics. Regression was used to estimate adjusted prevalence ratios (AdjPR) of participant-caregiver agreement on disability scores. Relative to HIV-negative adults, HIV-positive participants scoring at least 1 standard deviation (SD) below the norm on 2 or more neurocognitive tests were classified as having mild neurocognitive impairment and those scoring at least 2 SD below the norm on 2 or more neurocognitive tests were classified as having moderate-to-severe. Mean age was 36 years (SD 8.9), and 53% of participants were male. The rate of ADL agreement between participants and caregivers was 77% for HIV-positive and 87% for HIV-negative participants (AdjPR = 0.89, 95% CI 0.81–0.97, p = .01). Among HIV-positive participants, 41% had moderate neurocognitive impairment, 15% had severe neurocognitive impairment, and 44% were normal. For moderate neurocognitive impairment, the rate of ADL agreement was 69% and for severe neurocognitive impairment, it was 66%. Compared to non-impaired HIV-positive participants (86% ADL agreement), ADL agreement was lower with moderate impairment (AdjPR = 0.89, 95%CI 0.81–0.98, p = .023) and severe impairment (AdjPR = 0.77, 95%CI 0.63–0.95, p = .014). Gender, education and CD4 count were not associated with ADL agreement. HIV-positive persons with neurocognitive impairment have lower agreement with caregivers’ reports of ADL than HIV-positive persons without cognitive impairment.

Assessment and Diagnosis of HIV-Associated Dementia

HIV infection has long been known to result in dementia and other forms of neurocognitive deficits. The rate of HIV-associated dementia is decreasing, while mild forms of neurological impairments increase. Treatment of HIV infection has advanced, and patients are living longer, and are thus at a greater risk of cognitive decline. The HIV aging cohort is susceptible to neurocognitive impairment from other medical conditions that have a compounding effect on cognitive decline. The diagnosis of HIV-associated neurocognitive disorders involves identifying neurological dysfunction and then determining that HIV is the most probable cause. Implications for practice include early control of HIV replication and treatment of comorbid diseases.

Can computerized cognitive training reverse the diagnosis of HIV-associated neurocognitive disorder? A research protocol.

Nearly 50% of adults with HIV have some form of HIV-associated neurocognitive disorder (HAND), ranging from subtle to symptoms that interfere with everyday functioning and quality of life. HAND is diagnosed when a person performs more than 1 standard deviation below his or her normative mean on standardized measures in two or more cognitive domains (e.g., attention, speed of processing, verbal memory, executive functioning). As adults age with HIV, they are more likely to develop comorbidities such as cardiovascular disease, hypertension, and insulin resistance that may further contribute to poorer cognitive functioning and HAND. Certain computerized cognitive training programs may be able to improve specific cognitive domains in those with HIV. Such programs may be effective in changing the diagnosis of HAND in cognitively vulnerable adults. In this article, we describe the design and methods of TOPS-the Training On Purpose Study. In this on-going experimental study, 146 older adults (50+) with HAND are randomized to either: (i) an Individualized-Targeted Cognitive Training group, or (ii) a no-contact control group. This study targets those cognitive domains in which participants experience a deficit and trains participants with the corresponding computerized cognitive training program for that domain. An Individualized Targeted Cognitive Training approach using cognitive-domain-specific cognitive training programs may offer symptom relief to those individuals diagnosed with HAND, which may actually reverse this diagnosis. Given that these cognitive training programs are commercially available, this approach represents a potential paradigm shift in how HAND is considered and treated.

Evaluating the accuracy of self-report for the diagnosis of HIV-associated neurocognitive disorder (HAND): defining "symptomatic" versus "asymptomatic" HAND.

The criteria for differentiating symptomatic from asymptomatic HIV-associated neurocognitive disorder require evaluation of (1) cognitive impairment, (2) daily functioning declines, and (3) whether the functional declines are attributable to cognitive versus physical problems. Many providers rely only on self-report to evaluate these latter criteria. However, the accuracy of patient-provided information may be limited. This study evaluated the validity of self-assessment for HIV-associated neurocognitive disorder (HAND) diagnoses by comparing objective findings with self-report of criteria 2 and 3 above. Self-reports were used to stratify 277 cognitively impaired HIV+ individuals into functionally dependent (n = 159) and independent (n = 118) groups, followed by group comparisons of objective functional problems. The dependent group was then divided into those who self-attributed their functional dependence to only cognitive (n = 80) versus only physical (n = 79) causes, for further comparisons on objective findings. The functionally dependent group was significantly worse than the independent group on all objective disability characteristics except severity of cognitive impairment, while those who attributed their dependence to physical (versus cognitive) factors were similar on all objective physical, cognitive, and functioning variables. Of note, 28% of physical attributors showed no physical abnormalities on neuromedical examinations. Results suggest that patient report is consistently associated with objective measures of functional loss; in contrast, patient identification of physical versus cognitive causes is poorly associated with objective criteria. These findings caution against relying solely on patient self-report to determine whether functional disability in cognitively impaired HIV+ individuals can be attributed to strictly physical causes.

Cerebrospinal fluid analysis in the HIV infection and compartmentalization of HIV in the central nervous system.

The nervous system plays an important role in HIV infection. The purpose of this review is to discuss the indications for cerebrospinal fluid (CSF) analysis in HIV infection in clinical practice. CSF analysis in HIV infection is indicated for the diagnosis of opportunistic infections and co-infections, diagnosis of meningitis caused by HIV, quantification of HIV viral load, and analysis of CNS HIV compartmentalization. Although several CSF biomarkers have been investigated, none are clinically applicable. The capacity of HIV to generate genetic diversity, in association with the constitutional characteristics of the CNS, facilitates the generation of HIV quasispecies in the CNS that are distinct from HIV in the systemic circulation. CSF analysis has a well-defined and valuable role in the diagnosis of CNS infections in HIV/AIDS patients. Further research is necessary to establish a clinically applicable biomarker for the diagnosis of HIV-associated neurocognitive disorders.

Neurocognitive Assessment in the Diagnosis of HIV-Associated Neurocognitive Disorders

Neurocognitive assessment plays a central role in the diagnosis of human immunodeficiency virus- (HIV) associated neurocognitive disorders (HAND). The history of diagnostic categories and labeling of HIV-related neurological disorders is briefly presented. The current diagnostic nomenclature of HAND and the role of neurocognitive assessment is examined. Though neurocognitive testing is sensitive in assessing a broad range of cognitive impairments, neurocognitive testing is not specific to HAND without consideration of the impact on functional status, as well as confounding factors, including premorbid status.

Are practice effects an important confounder of longitudinal studies of HIV-associated neurocognitive disorders?

WCN 2013 No: 900 Topic: 5 — Dementia Are practice effects an important confounder of longitudinal studies of HIV-associated neurocognitive disorders? A.-C. Meyer, K. Robertson, E.A. Bukusi, G.L. Birbeck, C.R. Cohen, P. Oyaro, R.W. Price. Neurology, SFGH/University of California, San Francisco, CA, USA; Family AIDS Care and Education Services, Kenya Medical Research Institute, Nairobi, Kenya; Neurology, University of North Carolina, Chapel Hill, NC, USA; Neurology, Michigan State University, East Lansing, MI, USA; Obstetrics and Gynecology, University of California, San Francisco, CA, USA Background: The diagnosis of HIV-associated neurocognitive disorders (HAND) is based on neuropsychological testing. Scores on neuropsychological tests tend to improve with repeated administrations—the practice effect. Longitudinal studies of HANDmay be confounded by the practice effect. We determined the magnitude of the practice effect among HIV-uninfected individuals in Kenya. Methods: A comprehensive battery of seventeen neuropsychological tests designed to diagnose HAND was administered to 100 HIV-uninfected individuals in 2009. We traced these individuals, performed HIV-antibody testing, and re-administered the neuropsychological tests. Raw scores were converted to Z-scores, and practice effect was defined as the difference between the Z-scores at initial and repeat administrations. A clinically significant change was defined using the Reliable Change Index (standardized Z-score difference≥|1.64|). Results: Of 100 individuals initially studied, we located 69 of whom 47 participated. The median interval between testing was 98 weeks [Range: 83–130]. Mean age was 30 years, 26% were female, 26% had less than primary school education, and 24% had more than secondary school education. One individual was found to be HIVinfected and was excluded. Overall, practice effects ranged from −0.29 to 0.75 and, among the 33 individuals without neurologic or psychiatric co-morbidities, ranged from −0.26 to 0.72. Practice effects were significantly different from the null for Color Trails, Grooved Pegboard and WAIS-3 Digit Symbol. Between 3 and 9% of HIV-uninfected individuals had clinically significant improvements or declines. Conclusions: Practice effects may be an important confounder of longitudinal studies. Further research in larger andmore representative populations in sub-Saharan Africa is essential. doi:10.1016/j.jns.2013.07.1161 Abstract — WCN 2013 No: 663 Topic: 5 — Dementia Aerobic physical activity stabilizes cognitive status in patients with dementia WCN 2013 No: 663 Topic: 5 — Dementia Aerobic physical activity stabilizes cognitive status in patients with dementia M. Seijo-Martinez, J.M. Cancela, C. Ayan, S. Varela. Neurology, Xestion Integrada Pontevedra-Hospital do Salnes, Spain; Facultad de Ciencias de la Educacion y el Deporte, Universidad de Vigo,

Deficits in Self-Awareness Impact the Diagnosis of Asymptomatic Neurocognitive Impairment in HIV

A recent national survey of HIV(+) adults noted that nearly three-quarters of cognitively impaired individuals are categorized as having asymptomatic neurocognitive impairment (ANI), lacking documented compromise of everyday function. The clinical impact and long-term consequences of ANI are unknown and the importance of this asymptomatic diagnosis has raised concerns in clinical care settings where competing priorities often exist. In this study, we conducted structured tests of everyday functioning in a sample of HIV(+) subjects over 60 years of age and asked subjects to rate their performance relative to peers. We demonstrate that individuals with neuropsychological testing impairment often lack self-awareness of functional performance deficits. Specifically, ANI subjects rated functional performance similar to that of HIV-negative control subjects, despite noted deficits in objective measures of function. These findings have important implications for use of self-report of function in the diagnosis of HIV-associated neurocognitive disorders (HAND), likely underestimating symptomatic impairment.

Major Depressive Disorder, Cognitive Symptoms, and Neuropsychological Performance among Ethnically Diverse HIV+ Men and Women

Major depressive disorder (MDD), cognitive symptoms, and mild cognitive deficits commonly occur in HIV-infected individuals, despite highly active antiretroviral therapies. In this study, we compared neuropsychological performance and cognitive symptoms of 191 HIV-infected participants. Results indicated that participants with a formal diagnosis of current MDD performed significantly worse than participants without MDD in all seven neuropsychological domains evaluated, with the largest effect sizes in information processing speed, learning, and memory. In addition, a brief assessment of cognitive symptoms, derived from a comprehensive neuromedical interview, correlated significantly with neurocognitive functioning. Participants with MDD reported more cognitive symptoms and showed greater neurocognitive deficits than participants without MDD. These findings indicate that HIV-infected adults with MDD have more cognitive symptoms and worse neuropsychological performance than HIV-infected individuals without MDD. The results of this study have important implications for the diagnosis of HIV-associated neurocognitive disorders (HAND).

Diagnostic accuracy of the International HIV Dementia Scale and HIV Dementia Scale: A meta-analysis

This aim of this study was to assess the diagnostic accuracy of the International HIV Dementia Scale (IHDS) or HIV Dementia Scale (HDS) for the diagnosis of HIV-associated neurocognitive disorders (HAND). A comprehensive and systematic search was carried out in PubMed and EMBASE databases. Sensitivity, specificity, Q*-values, summary receiver operating characteristic curves and other measures of accuracy of IHDS or HDS in the diagnosis of HAND were summarized. Summary receiver operator characteristic (SROC) curve analysis for HAND data demonstrates a pooled sensitivity of 0.90 [95% confidence interval (CI), 0.88–0.91] and overall specificity of 0.96 (95% CI, 0.95–0.97) for IHDS, the Q*-value for IHDS was 0.9195 and the diagnostic odds ratio (DOR) was 162.28 (95% CI, 91.82–286.81). HDS had an overall sensitivity of 0.39 (95% CI, 0.34–0.43) and specificity of 0.90 (95% CI, 0.89–0.91), the Q*-value for HDS was 0.6321 and DOR was 5.81 (95% CI, 3.64–9.82). There was significant heterogeneity for studies that reported IHDS and HDS. This meta-analysis has shown that IHDS and HDS may offer high diagnostic performance accuracy for the detection of HAND in primary health care and resource-limited settings. IHDS and HDS may require reformed neuropsychological characterization of impairments in accordance with regional culture and language in future international studies.

Thinning of Retinal Nerve Fiber Layer Is Associated with Neurocognitive Impairment in HIV Infected Women (P01.263)

Objective: To evaluate if Optical Coherence Tomography (OCT) measurements of retinal nerve fiber layer (RNFL) correlate with diagnosis of HIV-associated Neurocognitive Disorders (HAND). Background HAND is associated with neuronal loss and eventual brain atrophy. In the era of combined antiretroviral therapy (CART) prior biomarkers of HAND are no longer useful. Since evidence supports that thinning of the (RNFL) as measured by OCT correlates with brain atrophy, axonal loss, and physical and cognitive disability in Multiple Sclerosis (MS) it is likely to be a good biomarker for HAND. Design/Methods: A pilot cross-sectional study nested in the longitudinal Hispanic/Latino Cohort of HIV-seropositive women. 30 women (15 HIV-seropositive, 5 with diagnosis of MS without history of optic neuritis, and 10 controls) were evaluated with neurological and neuropsychological exam. Cognition was determined using the modified AAN HIV dementia criteria. Only MS women with normal cognition were included. Among HIV-seropositive women, 7 had normal cognition/asymptomatic cognitive performance and 8 had symptomatic impairment (MCMD/HAD). OCT RNFL thickness average analysis test was performed in each of the subjects eyes. There was no significant difference in age and education among groups. OCT RNFL raw and normalized to the control group values were used. Statistics included non parametric and parametric associations and correlations. Results: Raw RNFL OCT values showed a significant association between the HIV-seropositive women without and with symptomatic impairment (p=0.002). Normalized RNFL OCT values confirm findings and demonstrated a significant association between HIV-seropositive without symptomatic impairment and those with MS (p Conclusions: This pilot study provides evidence for the use of OCT as a tool to evaluate brain dysfunction and neurodegeneration in HIV-seropositive women. This dysfunction may have a role in the diagnosis of HAND and could also represent a biomarker for HAND. Further studies should be performed to support current findings. Supported by: NIH: S11NS046278, U54NS43011, U54RR026139. Disclosure: Dr. De Jesus-Acosta has nothing to disclose. Dr. Rosado has nothing to disclose. Dr. Hechavarria has nothing to disclose. Dr. San Miguel has nothing to disclose. Dr. Serrano has nothing to disclose. Dr. Nath has nothing to disclose. Dr. Wojna has nothing to disclose.