Cognitive criteria in HIV: greater consensus is needed

A recently published Consensus Statement by Sam Nightingale and colleagues (Nightingale, S. et al. Cognitive impairment in people living with HIV: consensus recommendations for a new approach. Nat. Rev. Neurol . 19 , 424–433; 2023) 1 proposes a new approach to classifying cognitive impairment in people living with HIV. Although we applaud the efforts of the authors, other considerations are needed to ensure earlier and more consistent diagnosis, prevention and enhanced patient care. Furthermore, rather than rejecting the current criteria, a careful update of the HIV-associated neurocognitive disorder (HAND) criteria 2 would avoid an enormous historical loss resulting from new data becoming incomparable.