1 September 2007
New York State Department of Health - State/Local Government Agency [U.S.]
Summary,

GUIDELINE OBJECTIVE(S)

To provide guidelines for diagnosis and treatment of cognitive disorders in human immunodeficiency virus (HIV)-infected patients in primary care settings

TARGET POPULATION

Human immunodeficiency virus (HIV)-infected persons

INTERVENTIONS AND PRACTICES CONSIDERED

Diagnosis/Evaluation

1. Use of brief, standardized rating scale
2. Exclusion of other treatable, reversible causes of change in mental status
3. Complete evaluation including neuroimaging studies (computed tomography [CT], magnetic resonance imaging [MRI]) and lumbar puncture

Treatment/Management of HIV-associated Dementia (HAD)

1. Referral for psychiatric consultation, as appropriate
2. Antiretroviral drugs
3. Pharmacologic treatment of symptoms (psychotropic medications)
4. Non-pharmacologic treatment including
* Family support, nursing case management, nursing home care services
* Discussing advance directives and documenting the content of these discussions in the medical record

Treatment/Management of HIV-associated Delirium

1. Immediate referral of patients with signs and symptoms of delirium to the hospital
2. Correcting the underlying conditions that have led to delirium (low doses of antipsychotics with or without lorazepam)
3. Consultation with a psychiatrist

MAJOR OUTCOMES CONSIDERED

* Morbidity and mortality
* Cognitive status