Need to Revise Frascati Criteria for HIV-Associated Neurocognitive Disorders to Improve Relevance for Diverse Global Populations

Abstract

Worldwide, cognitive impairment is a frequent complication of HIV, and few treatments are available. Existing diagnostic criteria for cognitive disorders associated with HIV have limited diagnostic accuracy, hampering biomarker and therapeutic development. Furthermore, these criteria are not linked to clinically meaningful outcomes, limiting utility in clinical settings. Limitations in diagnostic accuracy are most pronounced in resource-limited settings where the burden of HIV is greatest, largely because of heavy reliance on neuropsychological testing with limited cross-cultural validity. Accurate and clinically meaningful diagnostic criteria validated in diverse populations will improve research and clinical care for cognitively impaired people living with HIV globally.