Until 2022, people living with HIV in the United Kingdom could not become commercial airline pilots. The fear was that the virus made them so vulnerable to neurocognitive impairment that steering a plane could endanger passengers. The same policy required pilots with HIV who already had their licenses to undergo stringent cognitive testing each year.
“I’m very pleased to say that [policy] was challenged, and the Civil Aviation Authority overturned it. That was frank discrimination as a result of a misrepresentation of the issue,” says Sam Nightingale, M.B.B.S., Ph.D., MRCP, DTMH, an associate professor and researcher at University of Cape Town’s Neuroscience Institute in South Africa.
Nightingale tells TheBodyPro he believes that the issue of neurocognitive impairment is often overstated in today’s context of effective antiretroviral therapy (ART). One of the culprits, in his opinion, is the current criteria for HIV-associated neurocognitive disorder (HAND). “The criteria typically define about 45% of any population of people with HIV as having HAND,” he says, because they do a poor job of identifying cognitive decline directly caused by HIV.
He argues that these high prevalence rates aren’t accurate in today’s world, and that they lead not only to increased stigma and discrimination from outside of the HIV community but also stoke fear within the community. This can lead people living with HIV to believe that they’re incredibly likely to experience neurocognitive decline as they age. “The HAND criteria no longer really represent the issues very well in the modern era,” he says. To address the issue, Nightingale and a panel of international experts recommended new criteria in 2023 called HIV-associated brain injury (HABI).
But not everyone agrees with the proposal. Lucette Cysique, Ph.D., is an associate professor at the Kirby Institute at the University of New South Wales in Australia and former chair of the NeuroCOVID International Neuropsychological Society. After reviewing the proposed changes, she and several of her colleagues responded that they are in favor of preserving existing HAND criteria, though she tells TheBodyPro that they do need to be updated.
Read the full story at TheBodyPro.
Source : TheBodyPro
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