The Impact of Human Immunodeficiency Virus on Cognitive Function

Although the initial focus in the characterization of acquired immunodeficiency syn-drome (AIDS) was on the array of opportunistic infections that could be pathologicallyand radiologically identified, it soon became clear that a great number of patientssuffered from cognitive deficits. Today, Centers for Disease Control (CDC) criteria forAIDS recognize the presence of dementia as a defining feature. Reports of cognitivechanges in otherwise asymptomatic seropositive individuals raise the possibility thatan important early feature of the disease could be the impact on intellectual function.Human immunodeficiency virus (HIV) is found centrally, in cerebrospinal fluid andbrain, even before any medical symptoms are evident, suggesting that there may be adirect effecton the central nervous system (CNS). In this chapter I review our investiga-tions and those of others of the neuropsychologic changes in HIV-positive asymptom-atic individuals, and briefly discuss dementia in AIDS