Shibani Mukerji, MD, PhD: What We Know About How HIV Affects Neurocognition

Shibani Mukerji, MD, PhD, Massachusetts General Hospital, Dana-Farber Cancer Institute: So I think we've learned quite a bit from the last decade really of what's going on in neuro HIV. People are living longer, they are on effective antiretroviral therapy, and we're finding that those individuals are still having a more rapid rate of neurological symptoms that includes cognitive decline, can include increased risk of stroke. And so I think what we're trying to do now is really study people that are aging on therapy and try to figure out what it is that's causing this sort of accelerated decline.

We know from CDC data in 2015 that about anywhere from 20—30% of individuals who are newly diagnosed are actually over the age of 50. And so it is a unique population, 40% of those individuals who are over age 55 are diagnosed, and considered late stage disease or considered having AIDS. And so it is a unique and at risk population, and it could be that providers don't think our over age populations are at risk for acquiring HIV. They themselves, people, don't think that they're necessarily at risk for acquiring HIV. And I think, you know, many individuals while they see their primary care doctor, they may be seeing other specialties like neurology, and it may behoove us to bring in neurology and other sort of specialties into the practice in seeing whether or not HIV should be part of their algorithm in terms of testing.