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HIV in the Brain - MANAGING COMORBIDITIES IN PATIENTS WITH HIV
 
 
  Shibani S. Mukerji MD, PhD
Massachusetts General Hospital, Division of Immunologic, Inflammatory and Infectious Neurological Diseases
 
SLIDES pdf attached
 
Download the PDF here
 
At IDWeek last week here is lecture by Dr Mukerji on HIV & the Brain, a review.....310,000 of 1 million with diagnosed HIV in the USA are between ages of 50-60 and 12% are over 60 - and they are all getting older!
 
1. "Therapeutic paradox: ARV has reduced prevalence of most severe manifestation of HAND (dementia) but not less severe manifestations. - HAND may continue to affect daily functions, quality of life, ART adherence"
 
2. "Neurocognitive Testing: The odds of neurocognitive impairment increased by 20% every decade of life in virologically suppressed PLWH who were ART adherent at 97% of visits over 2 years (median age 38 yrs)."
 
3. "Neurocognitive Testing: Some studies have shown that individuals with high CPE scores (≥ 9) had better cognitive scores and decreased odds of impairment (left). In contrast, other studies have shown that higher CPE scores are associated with increased risk of HIV dementia (right)" see slides below
 
4. Neurocognitive Studies: Among older (>50 years old) HIV+ adults compared to HIV- controls, tobacco use and diabetes was associated with worse cognitive scores (mean age 55 years).
 
5. Neurocognitive Studies: In longitudinal studies elevated total cholesterol predicted increased rate of cognitive decline among HIV+ adults (median age 51 years)
 
6. Neurocognitive Testing: Some studies have shown that individuals with high CPE scores (≥ 9) had better cognitive scores and decreased odds of impairment (left). In contrast, other studies have shown that higher CPE scores are associated with increased risk of HIV dementia (right)

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