Evolving strategies in the diagnosis and treatment of HIV-associated neurocognitive disorders

Despite significant progress in managing HIV infection, HIV - associated neurocognitive disorder (HAND) continues to be a concern even among HIV individuals with well - controlled infection. Current diagnostic strategies, primarily reliant on neuropsychological tests, neuroimaging, and biomarkers from blood and cerebrospinal fluid, alongside combination antiretroviral therapy, form the foundation of HAND management. However, these strategies often fail to identify early or mild HAND, particularly asymptomatic neurocognitive impairment, resulting in delayed diagnosis and intervention. Furthermore, the inability to perform in-depth molecular analyses and conduct longitudinal tracking limits therapeutic advancements. Emerging technologies - advanced neuroimaging, multi-omics, artificial intelligence, alongside simian immunodeficiency virus non-human primate models - are revolutionizing the field. These innovations offer unprecedented opportunities for deeper understanding of the disease mechanism, early detection, comprehensive monitoring, and personalized treatment strategies. Integrating these cutting-edge tools promises to reshape the landscape of HAND management, enhancing the quality of life for those living with HIV.