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Over 20 years have passed since the first reports of AIDS1 and the observation of an AIDS dementia complex among some HIV-infected patients,2 typically as a late and fulminant complication of the disease.3 Remarkable advances have occurred in delineating the underlying cellular and viral pathogenesis and the development of effective antiretroviral therapy mechanisms and treatment approaches (e.g., highly active antiretroviral therapy [HARRT]) which have led to marked improvements in survival.4 Consequently, the incidence of dementia has declined dramatically, though the possibility of brain dysfunction remains a major concern for people infected with HIV.
It is generally accepted that HIV-associated brain dysfunction is most common among symptomatic patients with severely impaired immune function and sustained elevated CSF viral loads. Whether chronic HIV infection causes neurocognitive dysfunction over time among patients who have never …
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