An overview of HIV-associated neurocognitive disorder in South Africa

Abstract

PURPOSE OF REVIEW : It is well established that South Africa has the highest prevalence of human immunodeficiency virus (HIV) worldwide. The increasing widespread availability of combination antiretroviral therapy (cART) has improved the life-expectancy of people living with HIV. cART has dramatically reduced morbidity, however many people living with HIV continue to experience central nervous system (CNS) complications including neuropsychiatric conditions such as depression, anxiety, and neurocognitive disorders. RECENT FINDINGS: The pathological effects of HIV on the CNS have not been well elucidated. There are limited studies focusing on the prevalence, screening, and treatment strategies of HIV-associated neurocognitive disorder (HAND) in South Africa. The few studies included in this review indicate that the prevalence of HAND may be higher than estimated. In addition, only a limited number of cases have been reported. This may be due to a lack of registry, screening tools, expertise, and awareness. SUMMARY : This review aimed to provide an overview of HAND in South Africa including prevalence, screening, and current treatment strategies. Whether South Africa has the necessary and effective screening tools remains to be determined; however, HAND screening should be mandated for all HIV-infected individuals. cART remains the mainstay treatment of HAND, currently there are no alternative treatment strategies other than adjuvant therapies. In addition, it is yet to be established whether cART plays a role in the development of HAND.