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Neuropsychological aspects of HIV infection.

There is considerable consensus regarding the entity, aetiology, and assessment of HIV-1-caused cognitive impairment. Early fears that this would be very common, and early in onset, have not been realized. Research and clinical criteria should reflect current statistical standards. The large cohorts, broad test batteries and repeated testing of population samples provide a special opportunity to resolve perennial questions regarding the relationship between mood, health, and cognitive functions. It appears that AZT prevents mild cognitive impairment associated with HIV-1, though there is no strong evidence that it treats frank HIV-1 dementia complex. The management of patients with dementia requires proper consideration, as even if the incidence of HIV-1 dementia complex is only 5-10%, this is still a substantial number of patients for population centres with large numbers of people with HIV and AIDS. The distressing nature of this condition, combined with the specialized management required for HIV itself, make it advisable that more nurses with psychiatric training are employed in wards or units specializing in HIV.