HIV Associated Neurocognitive Disorders (HAND) – Epidemiology Forecast – 2034
Description
Key Highlights
HIV-associated neurocognitive disorder (HAND) describes a variety of cognitive, motor, and mood disturbances affecting people living with HIV. It ranges from asymptomatic impairment and mild neurocognitive disorder to severe dementia.
According to DelveInsight estimates, there were 2 million diagnosed prevalent cases of HIV in the 7MM in 2024, which are projected to increase during forecast period (2025–2034).
In Japan, HIV prevalence itself is predominantly male driven, with men especially men who have sex with men (MSM) representing the majority of HIV cases. Naturally, this skews HAND prevalence toward males (~90%).
Distal Sensory Polyneuropathy (DSPN) is the most common form of HIV-associated peripheral neuropathy. DSPN significantly impairs quality of life, leading to sleep disturbances, functional disability, and increased risk of falls.
Among the 7MM, the prevalence of HAND varies significantly. In the US, it affects nearly half of all individuals living with HIV, while in EU4 and the UK, Spain shows the highest burden among member countries.
ANI is the most common HAND subtype, indicating many HIV-positive individuals have detectable cognitive changes without obvious symptoms.
The advent of ART has changed the landscape of HAND, with a decrease in the frequency of HIV encephalitis observed at autopsy. Initially, severe forms like HAD were more common, but now milder forms are more prevalent.
DelveInsight’s “HIV Associated Neurocognitive Disorders (HAND) – Epidemiology Forecast – 2034” report delivers an in-depth understanding of HAND, historical and forecasted epidemiology in the United States, EU4 (Germany, France, Italy, and Spain), and the United Kingdom, and Japan.
Geography Covered
The United States
EU4 (Germany, France, Italy, and Spain) and the United Kingdom
Japan
Study Period: 2020–2034
HIV-associated neurocognitive Disorders (HAND) Understanding
HIV Associated Neurocognitive Disorders (HAND) Overview
HAND encompasses a spectrum of cognitive, behavioral, and motor impairments caused by HIV’s impact on the central nervous system, ranging from asymptomatic neurocognitive impairment (ANI) to mild neurocognitive disorder (MND) and HIV-associated dementia (HAD). HIV enters the brain early, infecting macrophages and microglia, which triggers neuroinflammation, neuronal damage, and synaptic dysfunction. Risk factors include advanced disease, low CD4 count, high viral load, co-infections, aging, and cardiovascular/metabolic comorbidities. Symptoms may involve memory loss, attention deficits, slowed thinking, mood changes, and motor difficulties. Diagnosis uses neuropsychological testing, imaging, and HIV monitoring. While ART has reduced severe cases, milder forms remain common, requiring early treatment, comorbidity management, and cognitive support, with an ongoing need for better biomarkers and neuroprotective therapies.
HIV Associated Neurocognitive Disorders Diagnosis
Diagnosis of HAND typically starts when a person living with HIV experiences symptoms such as memory problems, slowed thinking, mood changes, or coordination difficulties. The healthcare provider gathers a detailed medical history, performs a neurological examination, and conducts neuropsychological tests to evaluate cognitive function. Brain MRI is used to exclude other causes, while HIV viral load, CD4 count, and CSF analysis help detect ongoing infection or inflammation. Combined findings confirm HAND and inform an individualized treatment approach.
Further details related to country-based variations are provided in the report…
HIV Associated Neurocognitive Disorders (HAND) Epidemiology
The HAND epidemiology chapter in the report provides historical as well as forecasted epidemiology segmented by diagnosed prevalent cases of HIV, diagnosed prevalent cases of HAND type-specific cases of HAND and gender-specific cases of HAND, diagnosed prevalent cases of distal sensory polyneuropathy in HIV, and the treated eligible patient pool of HAND in the 7MM covering the United States, EU4 (Germany, France, Italy, Spain) and the United Kingdom, and Japan from 2020 to 2034.
In 2024, an estimated 610,000 individuals in the US were diagnosed with HAND, with this number expected to rise over the forecast period (2025–2034).
In the US, among the type-specific cases, asymptomatic neurocognitive impairment accounts for the major contribution of about 70% followed by mild neurocognitive disorder.
The number of diagnosed prevalent cases of HAND was higher among males than females in the 7MM.
In EU4 and the UK, Distal Sensory Polyneuropathy in HIV accounted for about 40%.
HAND treatment eligible pool in the US is more than 500,000 in 2024.
KOL-Views
To keep up with current market trends, we take KOLs and SMEs' opinions working in the domain through primary research to fill the data gaps and validate our secondary research. Some of the leaders like MD, PhD, Research Project Manager, Director, and others. Their opinion helps to understand and validate current and emerging therapies and treatment patterns or HAND market trends. This will support the clients in potential upcoming novel treatments by identifying the overall scenario of the market and the unmet needs.
Delveinsight’s analysts connected with 15+ KOLs to gather insights; however, interviews were conducted with 10+ KOLs in the 7MM. University of Johns Hopkins University School of Medicine, The Icahn School of Medicine at Mount Sin, Yuka Kotozaki, Iwate Medical University, etc., were contacted. Their opinion helps understand and validate HAND epidemiology and market trends.
HIV Associated Neurocognitive Disorders (HAND) Report Insights
HIV Associated Neurocognitive Disorders (HAND) Report Insights
Patient population
Country-wise epidemiology distribution
HIV Associated Neurocognitive Disorders (HAND) Report Key Strengths
Ten-year forecast
7MM coverage
HAND epidemiology segmentation
FAQs
What are the disease risks, burdens, and unmet needs of HAND? What will be the growth opportunities across the 7MM concerning the patient population with HAND?
What is the historical and forecasted HAND patient pool in the US, EU4 (Germany, France, Italy, and Spain), the UK, and Japan?
Which gender accounts for a higher proportion of diagnosed HAND cases?
How are the diagnosed prevalent HAND cases distributed across different types?
Reasons to Buy
Insights on patient burden/disease prevalence, evolution in diagnosis, and factors contributing to the change in the epidemiology of the disease during the forecast years.
To understand key opinion leaders’ perspectives on the diagnostic challenges to overcome barriers in the future.
Detailed insights into various factors hampering disease diagnosis and other existing diagnostic challenges.
A detailed overview of type-specific and gender-specific cases of HAND is an inclusion.
HIV-associated neurocognitive disorder (HAND) describes a variety of cognitive, motor, and mood disturbances affecting people living with HIV. It ranges from asymptomatic impairment and mild neurocognitive disorder to severe dementia.
According to DelveInsight estimates, there were 2 million diagnosed prevalent cases of HIV in the 7MM in 2024, which are projected to increase during forecast period (2025–2034).
In Japan, HIV prevalence itself is predominantly male driven, with men especially men who have sex with men (MSM) representing the majority of HIV cases. Naturally, this skews HAND prevalence toward males (~90%).
Distal Sensory Polyneuropathy (DSPN) is the most common form of HIV-associated peripheral neuropathy. DSPN significantly impairs quality of life, leading to sleep disturbances, functional disability, and increased risk of falls.
Among the 7MM, the prevalence of HAND varies significantly. In the US, it affects nearly half of all individuals living with HIV, while in EU4 and the UK, Spain shows the highest burden among member countries.
ANI is the most common HAND subtype, indicating many HIV-positive individuals have detectable cognitive changes without obvious symptoms.
The advent of ART has changed the landscape of HAND, with a decrease in the frequency of HIV encephalitis observed at autopsy. Initially, severe forms like HAD were more common, but now milder forms are more prevalent.
DelveInsight’s “HIV Associated Neurocognitive Disorders (HAND) – Epidemiology Forecast – 2034” report delivers an in-depth understanding of HAND, historical and forecasted epidemiology in the United States, EU4 (Germany, France, Italy, and Spain), and the United Kingdom, and Japan.
Geography Covered
The United States
EU4 (Germany, France, Italy, and Spain) and the United Kingdom
Japan
Study Period: 2020–2034
HIV-associated neurocognitive Disorders (HAND) Understanding
HIV Associated Neurocognitive Disorders (HAND) Overview
HAND encompasses a spectrum of cognitive, behavioral, and motor impairments caused by HIV’s impact on the central nervous system, ranging from asymptomatic neurocognitive impairment (ANI) to mild neurocognitive disorder (MND) and HIV-associated dementia (HAD). HIV enters the brain early, infecting macrophages and microglia, which triggers neuroinflammation, neuronal damage, and synaptic dysfunction. Risk factors include advanced disease, low CD4 count, high viral load, co-infections, aging, and cardiovascular/metabolic comorbidities. Symptoms may involve memory loss, attention deficits, slowed thinking, mood changes, and motor difficulties. Diagnosis uses neuropsychological testing, imaging, and HIV monitoring. While ART has reduced severe cases, milder forms remain common, requiring early treatment, comorbidity management, and cognitive support, with an ongoing need for better biomarkers and neuroprotective therapies.
HIV Associated Neurocognitive Disorders Diagnosis
Diagnosis of HAND typically starts when a person living with HIV experiences symptoms such as memory problems, slowed thinking, mood changes, or coordination difficulties. The healthcare provider gathers a detailed medical history, performs a neurological examination, and conducts neuropsychological tests to evaluate cognitive function. Brain MRI is used to exclude other causes, while HIV viral load, CD4 count, and CSF analysis help detect ongoing infection or inflammation. Combined findings confirm HAND and inform an individualized treatment approach.
Further details related to country-based variations are provided in the report…
HIV Associated Neurocognitive Disorders (HAND) Epidemiology
The HAND epidemiology chapter in the report provides historical as well as forecasted epidemiology segmented by diagnosed prevalent cases of HIV, diagnosed prevalent cases of HAND type-specific cases of HAND and gender-specific cases of HAND, diagnosed prevalent cases of distal sensory polyneuropathy in HIV, and the treated eligible patient pool of HAND in the 7MM covering the United States, EU4 (Germany, France, Italy, Spain) and the United Kingdom, and Japan from 2020 to 2034.
In 2024, an estimated 610,000 individuals in the US were diagnosed with HAND, with this number expected to rise over the forecast period (2025–2034).
In the US, among the type-specific cases, asymptomatic neurocognitive impairment accounts for the major contribution of about 70% followed by mild neurocognitive disorder.
The number of diagnosed prevalent cases of HAND was higher among males than females in the 7MM.
In EU4 and the UK, Distal Sensory Polyneuropathy in HIV accounted for about 40%.
HAND treatment eligible pool in the US is more than 500,000 in 2024.
KOL-Views
To keep up with current market trends, we take KOLs and SMEs' opinions working in the domain through primary research to fill the data gaps and validate our secondary research. Some of the leaders like MD, PhD, Research Project Manager, Director, and others. Their opinion helps to understand and validate current and emerging therapies and treatment patterns or HAND market trends. This will support the clients in potential upcoming novel treatments by identifying the overall scenario of the market and the unmet needs.
Delveinsight’s analysts connected with 15+ KOLs to gather insights; however, interviews were conducted with 10+ KOLs in the 7MM. University of Johns Hopkins University School of Medicine, The Icahn School of Medicine at Mount Sin, Yuka Kotozaki, Iwate Medical University, etc., were contacted. Their opinion helps understand and validate HAND epidemiology and market trends.
HIV Associated Neurocognitive Disorders (HAND) Report Insights
HIV Associated Neurocognitive Disorders (HAND) Report Insights
Patient population
Country-wise epidemiology distribution
HIV Associated Neurocognitive Disorders (HAND) Report Key Strengths
Ten-year forecast
7MM coverage
HAND epidemiology segmentation
FAQs
What are the disease risks, burdens, and unmet needs of HAND? What will be the growth opportunities across the 7MM concerning the patient population with HAND?
What is the historical and forecasted HAND patient pool in the US, EU4 (Germany, France, Italy, and Spain), the UK, and Japan?
Which gender accounts for a higher proportion of diagnosed HAND cases?
How are the diagnosed prevalent HAND cases distributed across different types?
Reasons to Buy
Insights on patient burden/disease prevalence, evolution in diagnosis, and factors contributing to the change in the epidemiology of the disease during the forecast years.
To understand key opinion leaders’ perspectives on the diagnostic challenges to overcome barriers in the future.
Detailed insights into various factors hampering disease diagnosis and other existing diagnostic challenges.
A detailed overview of type-specific and gender-specific cases of HAND is an inclusion.
Table of Contents
60 Pages
- 1. Key Insights
- 2. Report Introduction
- 3. Epidemiology Forecast Methodology
- 4. HANDS Overview at a Glance
- 4.1. Patient Share (%) Distribution of HANDS in 2020
- 4.2. Patient Share (%) Distribution of HANDS in 2034
- 5. Disease Background and Overview
- 5.1. Introduction
- 5.2. Signs and Symptoms
- 5.3. Causes
- 5.4. Type
- 5.5. Pathophysiology
- 5.6. Clinical manifestations
- 5.7. Diagnosis
- 6.. Epidemiology and Patient Population of HANDS in the 7MM
- 6.1. Key Findings
- 6.2. Assumptions and Rationale
- 6.3. Total Diagnosed Prevalent Cases of HIV in the 7MM
- 6.4. Diagnosed Prevalent Cases of HANDS in the 7MM
- 6.5. The United States
- 6.5.1. Diagnosed Prevalent Cases of HIV in the United States
- 6.5.2. Diagnosed Prevalent Cases of HAND in the United States
- 6.5.3. Type-specific Cases of HAND in the United States
- 6.5.4. Gender-specific Cases of HAND in the United States
- 6.5.5. Diagnosed Prevalent Cases of Distal Sensory Polyneuropathy in the United States
- 6.5.6. Treated Eligible Pool of HNAD in the United States
- 6.6. EU4 and the UK
- 6.6.1. Diagnosed Prevalent Cases of HIV in EU4 and the UK
- 6.6.2. Diagnosed Prevalent Cases of HAND in EU4 and the UK
- 6.6.3. Type-specific Cases of HAND in EU4 and the UK
- 6.6.4. Gender-specific Cases of HAND in EU4 and the UK
- 6.6.5. Diagnosed Prevalent Cases of Distal Sensory Polyneuropathy in EU4 and the UK
- 6.6.6. Treated Eligible Pool of HNAD in EU4 and the UK
- 6.7. Japan
- 6.7.1. Diagnosed Prevalent Cases of HIV in Japan
- 6.7.2. Diagnosed Prevalent Cases of HAND in Japan
- 6.7.3. Type-specific Cases of HAND in Japan
- 6.7.4. Gender-specific Cases of HAND in Japan
- 6.7.5. Diagnosed Prevalent Cases of Distal Sensory Polyneuropathy in Japan
- 6.7.6. Treated Eligible Pool of HNAD in Japan
- 7. Patient Journey
- 7.1. Patient Journey Description
- 8. Unmet Needs
- 9. KOL Views
- 10. Appendix
- 10.1. Bibliography
- 10.2. Report Methodology
- 11. DelveInsight Capabilities
- 12. Disclaimer
- 13. About DelveInsight
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