Risk Factors

Neurocognitive impairment can be influenced by a number of factors:

  • lower educational level1
  • low CD4+/HIV-1 counts1
  • type 2 diabetes and multiple components of the metabolic syndrome2
  • comorbid/premorbid medical and psychiatric conditions, such as head injury, substance use disorder, depression
  • other forms of dementia/delirium

Predictors of HIV-associated neurocognitive disorders (HAND) include:3

  • a high HIV viral load
  • female gender
  • increasing age
  • poor virological control and low CD4+ counts
  • anemia
  • low body mass index
  • systemic symptoms
  • injection drug use


  1. De Ronchi D, Faranca I, Beradi D, et al. Risk factors for cognitive impairment in HIV-1-infected persons with different risk behaviors. Arch Neurol. 2002;59:812–818.
  2. Letendre SL, Ellis RJ, Everall I, Ances B, Bharti A, McCutchan JA. Neurologic complications of HIV disease and their treatment. Top HIV Med. 2009;17:46–56.
  3. McArthur JC, Brew BJ. HIV-associated neurocognitive disorders: is there a hidden epidemic? AIDS. 2010;24:1367–1370.