6th Edition of Neurology World Conference 2026

Abstract

The Changing Spectrum of Neurological Complications in HIV Infection in the Post-Antiretroviral Therapy Era: A Literature Review Background The widespread implementation of combination antiretroviral therapy (ART) has dramatically improved survival among people living with HIV. However, neurological complications remain a significant cause of morbidity despite effective viral suppression. The spectrum of neurological disorders has shifted from opportunistic infections toward chronic neurocognitive impairment, cerebrovascular disease, peripheral neuropathies, and treatment-related neurological conditions. Objective To review the current spectrum, epidemiology, pathophysiological mechanisms, diagnostic approaches, and management strategies of neurological complications associated with HIV infection in the post-ART era. Methods A narrative literature review was conducted using PubMed, Embase, and Scopus. Articles published in English during the last 15 years were screened using keywords related to HIV, antiretroviral therapy, neurocognitive disorders, cerebrovascular disease, peripheral neuropathy, opportunistic infections, and central nervous system manifestations. Relevant systematic reviews, clinical trials, observational studies, and international guidelines were included. Results Although ART has substantially reduced the incidence of severe opportunistic central nervous system infections, neurological complications continue to affect a considerable proportion of people living with HIV. HIV-associated neurocognitive disorders remain among the most prevalent manifestations despite viral suppression. Additionally, increasing evidence suggests a higher burden of ischemic stroke, peripheral neuropathies, epilepsy, movement disorders, and neuropsychiatric conditions related to chronic inflammation, immune activation, aging, and long-term ART exposure. Early diagnosis through neuroimaging, cerebrospinal fluid analysis, and neuropsychological assessment is essential to improve outcomes. Conclusion Neurological manifestations continue to represent an important clinical challenge in the post-ART era. Understanding the evolving spectrum of HIV-associated neurological disease is essential for timely diagnosis and multidisciplinary management. Continued research is needed to clarify the mechanisms underlying persistent neuroinflammation and to develop strategies aimed at reducing long-term neurological disability.