Neurocognitive Dysfunction With HIV Despite ART

Background: The true prevalence of HIV-associated neurocognitive disorders (HANDs) is uncertain, with estimates ranging from 7.5% to 45.0%. The standard of care for people with HIV (PWH) is life-long antiretroviral therapy (ART). Objective: To investigate the impact of effective long-term ART on the development of HAND. Design: Community-based, case-controlled, cross-sectional, observational cohort study. Participants: 155 community-dwelling PWH who had been treated for at least 15 years with ART (age, 53.2 ± 5.8 years; 21% female; 52% white; 40% black). They had no prior neurologic infection, no confounding neurologic disease, no ongoing illicit substance use, and no use of confounding medications. They were age- and sex-matched to 100 HIV-negative participants. Methods: For PWH, CD4 lymphocyte T cell counts, plasma HIV viral load, past and current ART regimens, and the number of years since HIV diagnosis since ART initiation were ascertained. All participants underwent very more...