Clinical interventions for HIV-associated neurocognitive disorder (hand) : a systematic review

Abstract

Despite the widespread use of antiretroviral therapy, HIV-associated neurocognitive disorder (HAND) continues to be one of the most common central nervous system (CNS) complications of human immunodeficiency virus (HIV), with the prevalence of the disorder remaining stable at pre-cART levels. HAND ranges in severity from mild to severe and can greatly impact the lives of individuals living with the disorder, often leading to morbidity in severe cases. The prevalence and severity of HAND underscores the need for safe, effective therapies to mitigate or eliminate the impacts of the disorder in order to improve the quality of life of infected individuals. While extensive research has been conducted to investigate the effectiveness of various clinical interventions in treating HAND, no comprehensive systematic review of these studies exists. The purpose of the present study was to conduct and present a systematic review of the literature regarding experimental studies of clinical therapeutic interventions for HAND. In total, 4,269 articles were returned in the initial database search, 13 of which met the inclusion criteria and were selected for inclusion in the review. The 13 articles examined in the final review included experimental investigations of both pharmaceutical and cognitive therapies for HAND. This review presents the current evidence that exists regarding empirically investigated interventions for HAND and broadly discusses trends, limitations, and gaps in the literature.