Treatment of HIV-Associated Neurocognitive Disorder

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Activity Dates: 04/27/2020 - 04/27/2023

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Target Audience

This course is designed for pharmacists, nurse practitioners or other health care professionals involved in the comprehensive medication management of psychiatric and/or neurological patients.

Session Summary

According to the Centers for Disease Control and Prevention, 1,008,929 individuals in the United States (U.S.) were identified as living with HIV in 2016 with 38,739 new cases of HIV diagnosed in the U.S. in 2017.1 In this population, HIV-associated neurocognitive disorder (HAND) is estimated to occur in approximately 50% of adults with HIV, which can cause cognitive slowing, difficulty concentrating, and impairment of memory. Per the 2007 Frascati criteria, HAND can be subcategorized into asymptomatic neurocognitive impairment (ANI), mild neurocognitive dementia (MND), and HIV-associated dementia (HAD). The severity of HAND has been decreased because of the use of combined antiretroviral (ARV) treatment, with HAD proposed to be reduced to 5%. However, the prevalence of milder forms (ANI and MND) has been increasing. In addition, it has been found that progression can occur in patients from ANI to MND and/or HAD. Various treatment strategies are being explored based on the different proposed neurogenesis of HAND, including the utility of increased CNS penetration, intensification, or earlier initiation of ARV treatment in addition to adjuvant medication treatments. There are no FDA-approved treatments for HAND at this time. Patients with HAND may already be receiving treatment by psychiatric providers for concurrent mental health diagnoses while others may present with undiagnosed HAND seeking treatment from a psychiatric provider secondary to the nature of the symptoms. Clinical psychiatric pharmacists are in a position to assist in the identification of a potential diagnosis of HAND in patients diagnosed with HIV in addition to serving as a resource to other clinical providers in regard to treatment recommendations. 
 
ARV treatments for HIV can cause a variety of tolerability issues including some neurologic and psychiatric adverse events including insomnia, changes in mood, hallucinations, and neuropathy. ARV treatments are associated with numerous drug interactions that must be carefully evaluated and addressed. Clinical psychiatric pharmacists are in a position to identify and manage these adverse events and drug interactions. in patients with HIV and HAND.

Course Requirements

You will proceed through the following steps to satisfactorily complete this course:

  • Sign in (or create a FREE account).
  • Register for this course.
  • Review the full content of the activity and reflect upon its teachings.
  • Complete the post-test at the end of the activity no later than the closing activity date.
  • Complete the evaluation at the end of the activity.
  • If necessary, complete the post-test retest no later than the closing activity date.
  • Receive a passing grade (70%).
  • Provide the necessary details in your profile to ensure correct reporting by AAPP to CPE Monitor.

Upon successful completion, ACPE credit is reported within 24 hours to CPE Monitor although transcripts can be retrieved by participants online in their ACPE Transcript.

Faculty Information and Disclosures

Jennifer E. Thomas, PharmD, BCPP, AAHIVP

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Learning Objectives

  1. Evaluate the proposed neurogenesis, associated risk-factors for, and symptoms of HIV-associated neurocognitive disorder (HAND). 
  2. Analyze treatment options for HAND.
  3. Assess treatment plans for potential adverse events and drug-drug interactions in patients with HAND.

Continuing Education Credit and Disclosures

Activity Dates: 04/27/2020 - 04/27/2023
ACPE Contact Hours: 1
ACPE Number: 0284-0000-20-040-H01-P (Application)
Nursing Credit Reminder: Note that ACPE credit is accepted for certification renewal.

ACPEThe College of Psychiatric and Neurologic Pharmacists is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.

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