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This page is an AI-assisted Turkish summary of the study presented at the 26th World Congress of Psychiatry. The study belongs to the presenting authors; please refer to the original source when citing it.

HIV-associated neurocognitive disorders: from diagnostic criteria to clinical practice

Hiv associated neurocognitive disorders – from diagnostic criteria to clinical practice

The HIV-associated brain injury (HABI) framework, proposed as a replacement for the Frascati criteria, offers a more comprehensive and clinically applicable approach to HIV-associated cognitive impairment by reducing reliance on neuropsychological test scores.

Despite effective antiretroviral therapy (ART), cognitive impairment remains a significant source of morbidity among people living with HIV; HIV-associated neurocognitive disorders (HAND) persist even with viral suppression, and their multifactorial nature challenges traditional diagnostic frameworks. This presentation aims to review the transition from the Frascati HAND criteria to the HIV-associated brain injury (HABI) framework and its implications for clinical care through a review of the current literature. HIV enters the central nervous system shortly after infection, establishing persistent reservoirs that contribute to chronic neuroinflammation, accelerated aging, and cognitive dysfunction. The Frascati criteria, which classify impairment primarily on the basis of neuropsychological test performance, have been criticized for high misclassification rates and limited clinical applicability; in response, the International HIV-Cognition Working Group proposed the concept of HABI, which views HIV as only one of several factors contributing to cognitive impairment and emphasizes objective evidence of neuropathology. HABI integrates cognitive symptoms, neuropsychological assessment, neurological examination, neuroimaging, biomarkers, and clinical history, distinguishes active brain injury from past (legacy) injury, and reduces reliance on test scores alone, providing a more flexible and clinically meaningful framework, particularly in resource-limited settings where validated assessment tools may not be available. In conclusion, the HABI framework offers a more comprehensive and clinically applicable approach with the potential to improve diagnosis across diverse healthcare settings.

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