Assessment of HIV-related mental status changes

Last reviewed: 24 Apr 2022
Last updated: 18 May 2022

Summary

Differentials

Common

  • Asymptomatic neurocognitive impairment
  • Mild neurocognitive disorder (MND)
  • Antiretroviral adverse effects
  • Toxoplasmosis encephalitis/abscess
  • Cryptococcal meningitis/abscess
  • Mycobacterium tuberculosis meningitis/abscess
  • Depression
  • Substance use
  • Alcohol-use disorder
  • Hepatitis C co-infection
  • Hepatitis B co-infection
  • Hypogonadism
Full details

Uncommon

  • HIV-associated dementia (HAD)
  • Immune reconstitution inflammatory syndrome
  • Neurosyphilis
  • Cytomegalovirus (CMV) encephalitis
  • Progressive multifocal leukoencephalopathy
  • Herpes virus encephalitis
  • Varicella zoster encephalitis
  • Primary central nervous system (CNS) lymphoma
  • Vitamin B12 deficiency
  • Stroke
  • Hypothyroidism
  • Adrenal insufficiency
Full details

Contributors

Authors

Marie-Josée Brouillette, MD, FRCPC

Associate Professor of Psychiatry/Consultant Psychiatrist

Chronic Viral Illness Service of the McGill University Health Centre

McGill University

Montreal

Canada

Disclosures

MJB declares that she has no competing interests.

Mark Hull, MD, MHSc, FRCPC

Clinical Assistant Professor

University of British Columbia

Division of AIDS

Faculty of Medicine

Vancouver

Canada

Disclosures

MH has received honoraria for speaking engagements and advisory boards from Gilead and Merck. These have been paid to his institution.

Marianne Harris, MD

Clinical Assistant Professor

University of British Columbia

Department of Family Practice

Faculty of Medicine

Vancouver

Canada

Disclosures

MH has served as a consultant and/or advisory board member for Gilead Sciences Canada Inc., Merck Canada Inc., and ViiV Healthcare. Honoraria are administered by the institution.

Acknowledgements

Dr Marie-Josée Brouillette, Dr Mark Hull, and Dr Marianne Harris would like to gratefully acknowledge Dr Martin Repetto, the previous contributor to this topic. MR declares that he has no competing interests.

Peer reviewers

Joseph R. Zunt, MD, MPH

Associate Professor of Neurology

Harborview Medical Center

Seattle

WA

Disclosures

JRZ has received funding from NIH for research.

John Frater, MB BS, PhD

Consultant in Infectious Diseases

Nuffield Department of Experimental Medicine

University of Oxford

Oxford

UK

Disclosures

JF has received the MRC Clinician Scientist award.

  • Guidelines

    • EACS guidelines: version 10.1
    • Guidelines for the prevention and treatment of opportunistic infections in HIV-infected adults and adolescents
    Guidelines
  • Patient leaflets

    Alzheimer's disease and other kinds of dementia

    Alzheimer's disease and other types of dementia: what treatments work?

    More Patient leaflets
  • padlock-lockedLog in or subscribe to access all of BMJ Best Practice

Use of this content is subject to our disclaimer