The Mind Exchange Program provides a guide of recommendations for the clinical management of neurocognitive disorders in HIV | Fight AIDS Foundation

The Mind Exchange Program provides a guide of recommendations for the clinical management of neurocognitive disorders in HIV


Despite advances in HIV treatment, the damages it can cause in the central nervous system (CNS) are still frequent.

The HIV-associated neurocognitive disorder is called HAND, and is defined by the appearance of slight changes in memory, concentration, motor, or other cognitive functions. These variations may be associated with lower medication adherence, decreased ability to perform daily living tasks, a lower quality of life, greater difficulty in obtaining employment, and even, with reduced survival.

HIV hides in the central nervous system, where it is not known in detail what is its survival or evolution. This difficults the clinical monitoring of these patients and health professionals show a growing interest in knowing what these changes are and how to diagnose, treat, or even prevent them.

To answer this demand of clinicians, the MIND EXCHANGE program was established with the collaboration of the biopharmaceutical company Abbvie, with the aim of reaching a consensus among international experts to provide specific recommendations for addressing disorders associated with HIV neurocongnitive disorders in daily clinical practice.

Sixty-six specialists from several countries (including HIV clinicians, neurologists, neuropsychologists, clinical psychologists and psychiatrists with expertise in HIV patients) collaborated in the Mind Exchange program, which took place between February 2011 and January 2012.

The program was overseen by a steering committee of five experts, among which was Jose A. Muñoz-Moreno from the Foundation Fighting AIDS. Were also part of this committee infectious disease specialists Andrea Antinori from Italy, and Scott Letendre, from the U.S.A, German neurologist Gabriele Arendt, and the American psychiatrist Igor Grant.

A group of international experts generated an extensive list of 83 questions on five topics: the detection, diagnosis, monitoring, treatment and prevention of HAND. Finally, the list was reduced to 14 questions considered of high clinical importance. To address them, the five members of the steering committee conducted a comprehensive search of the existing  literature, both in publications and in communications at international conferences, and consulted the opinion of several professionals.

Finally, a meeting was held in Frankfurt in November 2011 where the level of agreement of experts involved with every draft response  was determined, to arrive at an overall consensus on each of them.

Program results have been published in the international journal Clinical Infectious Diseases this April.

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