Children and adolescents with perinatally-acquired HIV infection (PHIV+) are vulnerable to
subtle to severe neurocognitive problems during development. Introduction of combination
antiretroviral therapy (cART) has resulted in a dramatic decrease in incidence of severe
neurocognitive impairments; however, HIV-infected children on suppressive cART
regimens may still experience neurocognitive deficits.[1-4] HIV-associated neurocognitive
disorders are thought to be due to virus-specific effects via direct infection of brain
macrophages and microglia, and indirectly via virus-induced immune activation and
inflammatory responses.[5-7] cART improves immunologic status and produces viral
suppression in the peripheral blood; however, it remains unclear what impact cART has on
the development of HIV-associated neurocognitive disorders in children as they age through
adolescence and young adulthood.