Despite longstanding acknowledgement of the heterogeneity of HIV-associated neurocognitive disorders (HAND), existing HAND diagnostic methods classify according to the degree of impairment, without regard to the pattern of neuropsychological strengths and weaknesses. Research in mild cognitive impairment (MCI) has demonstrated that classifying individuals into subtypes by both their level and pattern of impairment, using either conventional or statistical methods, has etiologic and prognostic utility. Methods for characterizing the heterogeneity of MCI provide a framework that can be applied to other disorders and may be useful in clarifying some of the current challenges in the study of HAND. A small number of studies have applied these methods to examine the heterogeneity of neurocognitive function among individuals with HIV. Most have supported the existence of multiple subtypes of neurocognitive impairment, with some evidence for distinct clinicodemographic features of these subtypes, but a number of gaps exist. Following a review of diagnostic methods and challenges in the study of HAND, we summarize the literature regarding conventional and empirical subtypes of MCI and HAND and identify directions for future research regarding neurocognitive heterogeneity in HIV infection.

中文翻译：

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HIV感染中神经心理障碍的异质性：轻度认知障碍的贡献

尽管长期以来一直认识到与艾滋病毒有关的神经认知障碍（HAND）的异质性，但现有的HAND诊断方法是根据损伤的程度进行分类的，而不考虑神经心理学优点和缺点的模式。对轻度认知障碍（MCI）的研究表明，使用常规方法或统计学方法，根据其障碍的程度和模式将个体分为亚型，具有病因学和预后方面的作用。表征MCI异质性的方法提供了可应用于其他疾病的框架，可能有助于阐明HAND研究中的一些当前挑战。少数研究已将这些方法应用于检查HIV感染者中神经认知功能的异质性。大多数人支持神经认知障碍的多种亚型的存在，有证据表明这些亚型具有明显的临床脑电图特征，但存在许多空白。在回顾了HAND研究中的诊断方法和挑战之后，我们总结了有关MCI和HAND常规和经验亚型的文献，并确定了有关HIV感染中神经认知异质性的未来研究方向。