HIV-associated neurocognitive disorder (HAND)

People with HIV and AIDS sometimes develop cognitive impairment, particularly in the later stages of their condition.

What is HIV-associated neurocognitive disorder (HAND)?

Learn more about HIV-related cognitive impairment

Most people in the UK who are living with human immunodeficiency virus (HIV) can take very effective drugs called ‘combination antiretroviral therapy’ (cART). These drugs keep the levels of the virus in the person’s system down to very low levels.

Before cART some people with HIV would go on to develop dementia, but this is now uncommon. However, many people who have HIV still experience a milder type of cognitive impairment, such as problems with their memory and thinking. This is called HIV-associated neurocognitive disorder (HAND).

People with HAND may have difficulties with their:

  • concentration
  • memory
  • planning
  • organising
  • decision-making.

These symptoms usually remain stable over time, rather than progressing to dementia. The person may also have problems with their mood, such as depression or irritability.

If someone has recently been diagnosed with HIV they should have their cognitive and emotional wellbeing assessed within three months. They should then be re-assessed at least once a year.

HIV causes an infection that weakens a person’s immune system. This makes it harder for their body to fight infections and disease. There is ongoing research to find out whether HIV causes Alzheimer’s disease to develop more quickly in a person’s brain. Until more research is done it is difficult to know how a person’s risk of developing dementia might increase if they live with HIV for many years. Older people who have HIV should visit their GP or HIV specialist if they develop problems with their thinking or mood.

The Mildmay Hospital in London gives people with HAND inpatient and day care services. For more information see Rarer types of dementia - other resources.

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