Neuroimaging of HIV-associated neurocognitive disorders (HAND)

Curr Opin HIV AIDS. 2014 Nov;9(6):545-51. doi: 10.1097/COH.0000000000000112.


Purpose of review: HIV enters the brain after initial infection, and with time can lead to HIV-associated neurocognitive disorders (HAND). Although the introduction of combination antiretroviral therapy has reduced the more severe forms of HAND, milder forms are still highly prevalent. The 'gold standard' for HAND diagnosis remains detailed neuropsychological performance testing but additional biomarkers (including neuroimaging) may assist in early detection of HAND.

Recent findings: We review the application of recently developed noninvasive MRI and PET techniques in HIV+ individuals. In particular, magnetic resonance spectroscopy may be more sensitive than conventional MRI alone in detecting HIV associated changes. Diffusion tensor imaging has become increasingly popular for assessing changes in white matter structural integrity due to HIV. Both functional MRI and PET have been limitedly performed but could provide keys for characterizing neuropathophysiologic changes due to HIV.

Summary: It is hoped that continued progress will allow novel neuroimaging methods to be included in future HAND management guidelines.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Central Nervous System Diseases / diagnosis
  • Central Nervous System Diseases / virology*
  • Cognition Disorders / diagnosis
  • Cognition Disorders / virology*
  • HIV Infections / pathology*
  • HIV Infections / psychology*
  • Humans
  • Magnetic Resonance Imaging
  • Neuroimaging / methods*
  • Positron-Emission Tomography