HIV-associated neurocognitive disorder (HAND) is a major neurological complication in HIV-positive persons. It impairs cognitive activity, including memory, learning, attention, problem solving and decision making. Symptoms can vary from confusion to forgetfulness, behavioural changes, nerve pain and sometimes apathy.
The widespread use of combined antiretroviral treatment has reduced the incidence of the most severe form of the disorder, HIV-associated dementia, from 8% to 2%. However, the prevalence of mild to moderate degrees of neurocognitive deficits persists in up to 50% of sufferers, with phases of relapse and remission. Symptoms are not severe enough to be referred to as dementia, yet they impact on quality of life and independence.
Research questions being asked at NeuRA include: to what extent does HAND regress with antiretroviral treatment or cognitive training? Can early treatment reduce HAND incidence? Are HIV-positive persons more likely to have HAND as they age, and could this accelerate common neurodegenerative diseases? Do alcohol and substance use disorders exacerbate HAND? How can we improve the early detection of HAND using improved neuropsychological and/or neuroimaging methods?
To answer these questions, Dr. Lucette Cysique leads and co-leads several studies in Australia working with partners including the UNSW, St Vincent’s Hospital, The Alfred Hospital in Melbourne, and HIV clinics in NSW. Internationally, the University of California San Diego and McGill University in Canada are also part of the research program. NeuRA’s research is pivotal to this exchange network.
A pilot study to assess if computerised cognitive training will improve symptoms of HAND is currently recruiting participants.