HIV-associated neurocognitive disorders

HIV infection is associated with disturbances in brain function referred to as HIV-associated neurocognitive disorders (HAND). This literature review outlines the recently revised diagnostic criteria for the range of HAND from the earliest to the more advanced stages: (i) asymptomatic neurocognitive impairment; (ii) mild neurocognitive disorder; and (iii) HIVassociated dementia. Relevant literature is also reviewed regarding the differential impact upon component cognitive domains known to be affected in HAND; which in turn should ideally be targeted during clinical and neuropsychological assessments: psychomotor and information processing speed; learning and memory; attention and working memory; speech and language; executive functioning and visuospatial functioning. A discussion outlining the neuropsychological tools used in the diagnostic screening of HAND is also included. The central mechanisms of HAND appear to revolve primarily around psychomotor slowing and cognitive control over mental operations; possibly reflecting the influence of disrupted fronto-striatal circuits on distributed neural networks critical to cognitive functions. The accurate assessment and diagnosis of HAND depends on meeting the need for statistically sound neuropsychological assessment techniques that may be used confidently in assessing South African populations; as well as the development of relevant norms for comparison of test performance data

Aspects epidemiologiques; cliniques et evolutifs des manifestations neurologiques associees a l'infection retrovirale: etude retrospective sur 11 ans

A partir d'une etude retrospective de 93 cas de neurosida colliges sur une periode de 11 ans (1987-1997); les auteurs evaluent la seroprevalence de l'infection retrovirale dans le Service de Neurologie de l'Hopital de Fann (Dakar; Senegal); etudient les facteurs socio-demographiques et determinent les principales manifestations neurologiques et leur impact sur la survie des patients. Les resultats de cette etude ayant teste 1151 patients ont ete presentes et discutes; sous divers aspects

L'encephalopathie associee a l'infection VIH chez l'enfant : A propos de 19 cas observes aux Cliniques de Universitaires de Kinshasa

De 1989 a 1995; 29 enfants ont presente une encephalopathie liee a l'infection a VIH et leur moyenne d'age est de 5 ans (extremes 9 mois et 13 ans). La transmission est materno-foetale dans 23 cas; secondaire a une transfusion dans 2 cas et le mode de contamination est non etabli chez 4 malades. Les manifestations en sont principalement les troubles du tonus (50 pour cent de cas); les troubles du comportement 30 pour cent) et l'alteration de la conscience. L'encephalopatie observee est statique et elle est irreversible