27th June 2023

HIV associated neurocognitive disorder (HAND)

HAND is caused by HIV in the brain and inflammation of the brain caused by immunosuppression, and results in neuropsychiatric decline. Clinical features include:

• Loss of attention/ concentration
• Motor slowing
• Altered behaviour

These may be subtle and may require repeated neuropsychiatric testing in cases of mild neurocognitive disorder to be picked up. Risk factors for HAND include: age >50; hypertension; diabetes; hypercholesterolaemia; Hepatitis C infection; recreational drug abuse and low cognitive reserve.

The most important aspect of the treatment of HAND is antiretroviral therapy and management of comorbidities.