HIV and Disability Law

People with HIV responding well the antiretroviral (ARV) therapy commonly experience at least minor signs of thinking and memory problems, according to a study published online December 7 in AIDS. Most problems were so minor, however, that people didn’t realize they had any dysfunction. The study does not predict whether or how rapidly these problems might worsen.

Researchers studying neurocognitive disorders in people living with HIV—which can encompass problems with thinking, reasoning, memory, emotions and movement—once focused almost predominantly on the most extreme and debilitating version, AIDS dementia complex (ADC). As survival and the risk of AIDS-related diseases have dramatically improved in recent years, researchers are now focusing on HIV-associated neurocognitive disorder (HAND): a cluster of minor but increasingly common central nervous system problems in HIV-positive people.

In the past two years in particular, published studies have shown that HAND might be most common in people who are not on ARV therapy and who have uncontrolled HIV replication. To determine the prevalence of HAND among people responding well to ARV therapy, Samanta Simioni, MD, from the Centre Hospitalier Universitaire Vaudois, in Lausanne, Switzerland, and her colleagues assessed the cognitive function of 100 HIV-positive people who had successfully suppressed their viral loads for, on average, at least three years. Most of the participants were male, and the average age was 46.

HAND was very common. In all, 74 percent were diagnosed with some degree of the disease. The majority of people diagnosed with HAND, however, did not have symptoms severe enough to be noticeable to the participants—though they did have signs of the disorder based on sophisticated assessments.